Provider Demographics
NPI:1912365107
Name:JAMES H. GILLESPIE, JR., DMD
Entity Type:Organization
Organization Name:JAMES H. GILLESPIE, JR., DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-250-6813
Mailing Address - Street 1:2660 10TH AVE S STE 632
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1627
Mailing Address - Country:US
Mailing Address - Phone:205-250-6813
Mailing Address - Fax:205-250-6843
Practice Address - Street 1:2660 10TH AVE S STE 632
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1627
Practice Address - Country:US
Practice Address - Phone:205-250-6813
Practice Address - Fax:205-250-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty