Provider Demographics
NPI:1538294921
Name:C.D. HARRELL III DMD
Entity Type:Organization
Organization Name:C.D. HARRELL III DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-928-8221
Mailing Address - Street 1:71-A NORTH SECTION ST.
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532
Mailing Address - Country:US
Mailing Address - Phone:251-928-8221
Mailing Address - Fax:251-928-8229
Practice Address - Street 1:71A N. SECTION ST.
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532
Practice Address - Country:US
Practice Address - Phone:251-928-8221
Practice Address - Fax:251-928-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL45121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty