Provider Demographics
NPI:1003918467
Name:ASWELL, JAMES DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:ASWELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 THE MALL WAY
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35504
Mailing Address - Country:US
Mailing Address - Phone:205-387-0810
Mailing Address - Fax:
Practice Address - Street 1:441 THE MALL WAY
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35504
Practice Address - Country:US
Practice Address - Phone:205-387-0810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL32231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL90180OtherBLUE CROSS BLUE SHIELD AL