Provider Demographics
NPI:1780890467
Name:STOVALL, NZINGHA HARRIS (DMD)
Entity type:Individual
Prefix:DR
First Name:NZINGHA
Middle Name:HARRIS
Last Name:STOVALL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 BERRY CHASE PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-6896
Mailing Address - Country:US
Mailing Address - Phone:334-271-2001
Mailing Address - Fax:334-271-2330
Practice Address - Street 1:2030 BERRY CHASE PL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-6896
Practice Address - Country:US
Practice Address - Phone:334-271-2001
Practice Address - Fax:334-271-2330
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL54781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice