Provider Demographics
NPI:1508604034
Name:TWELVE DENTAL
Entity type:Organization
Organization Name:TWELVE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-907-3629
Mailing Address - Street 1:7040 GADSDEN HWY STE 112
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-2691
Mailing Address - Country:US
Mailing Address - Phone:205-655-7645
Mailing Address - Fax:
Practice Address - Street 1:7040 GADSDEN HWY STE 112
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-2691
Practice Address - Country:US
Practice Address - Phone:205-655-7645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty