Provider Demographics
NPI:1184822256
Name:PRICE, STEPHEN RONALD
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RONALD
Last Name:PRICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 STRATFORD ROAD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-350-5290
Mailing Address - Fax:256-350-5287
Practice Address - Street 1:1320 STRATFORD ROAD SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601
Practice Address - Country:US
Practice Address - Phone:256-350-5290
Practice Address - Fax:256-350-5287
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34511223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics