Provider Demographics
NPI:1720257603
Name:VLACHOS, CHRISTOS CANELLOS (DMD, DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOS
Middle Name:CANELLOS
Last Name:VLACHOS
Suffix:
Gender:M
Credentials:DMD, DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3045 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4169
Mailing Address - Country:US
Mailing Address - Phone:205-871-5557
Mailing Address - Fax:205-414-1930
Practice Address - Street 1:3045 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4169
Practice Address - Country:US
Practice Address - Phone:205-871-5557
Practice Address - Fax:205-414-1930
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL45511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics