Provider Demographics
NPI:1477809895
Name:JONATHAN B. ECHOLS
Entity Type:Organization
Organization Name:JONATHAN B. ECHOLS
Other - Org Name:CULLMAN COSMETIC & FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ECHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-734-7151
Mailing Address - Street 1:311 6TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-3656
Mailing Address - Country:US
Mailing Address - Phone:256-734-7151
Mailing Address - Fax:256-734-7017
Practice Address - Street 1:311 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3656
Practice Address - Country:US
Practice Address - Phone:256-734-7151
Practice Address - Fax:256-734-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty