Provider Demographics
NPI:1780056861
Name:JAMES B. DONAGHEY II DMD, PC
Entity type:Organization
Organization Name:JAMES B. DONAGHEY II DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:DONAGHEY
Authorized Official - Suffix:II
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-342-3188
Mailing Address - Street 1:4626 BIT AND SPUR RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-2646
Mailing Address - Country:US
Mailing Address - Phone:251-342-3188
Mailing Address - Fax:251-342-3526
Practice Address - Street 1:4626 BIT AND SPUR RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-2646
Practice Address - Country:US
Practice Address - Phone:251-342-3188
Practice Address - Fax:251-342-3526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3753261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental