Provider Demographics
NPI:1912014846
Name:HARRELL, WILLIAM EDWARD JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:HARRELL
Suffix:JR
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 1:163 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-1934
Mailing Address - Country:US
Mailing Address - Phone:256-234-6353
Mailing Address - Fax:256-234-6713
Practice Address - Street 1:163 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-1934
Practice Address - Country:US
Practice Address - Phone:256-234-6353
Practice Address - Fax:256-234-6713
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL31691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL93148OtherBLUE CROSS #