Provider Demographics
NPI:1356698690
Name:JAMES V MILLS JR DMD
Entity type:Organization
Organization Name:JAMES V MILLS JR DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:V
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-633-3636
Mailing Address - Street 1:621 HELEN KELLER BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-2962
Mailing Address - Country:US
Mailing Address - Phone:205-633-3636
Mailing Address - Fax:205-633-3672
Practice Address - Street 1:621 HELEN KELLER BLVD STE 300
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2962
Practice Address - Country:US
Practice Address - Phone:205-633-3636
Practice Address - Fax:205-633-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL36911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty