Provider Demographics
NPI:1760578967
Name:DOWNS, NOLAN D (DMD)
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:D
Last Name:DOWNS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361453
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35236-1453
Mailing Address - Country:US
Mailing Address - Phone:205-823-7387
Mailing Address - Fax:205-823-2915
Practice Address - Street 1:1957 HOOVER CT
Practice Address - Street 2:SUITE 210
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3622
Practice Address - Country:US
Practice Address - Phone:205-823-7387
Practice Address - Fax:205-823-2915
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009917685Medicaid