Provider Demographics
NPI:1831282565
Name:NAILS, ALICIA JOHNSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:JOHNSON
Last Name:NAILS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 DANVILLE ROAD SW
Mailing Address - Street 2:SUITE R
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603
Mailing Address - Country:US
Mailing Address - Phone:256-355-1557
Mailing Address - Fax:
Practice Address - Street 1:2426 DANVILLE ROAD SW
Practice Address - Street 2:SUITE R
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603
Practice Address - Country:US
Practice Address - Phone:256-355-1557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL50211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice