Provider Demographics
NPI:1811057631
Name:MITCHELL, SONYA T (DMD, MSHA)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:T
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DMD, MSHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 3RD AVE S
Mailing Address - Street 2:SDB BOX 82
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0002
Mailing Address - Country:US
Mailing Address - Phone:205-934-1062
Mailing Address - Fax:205-975-2883
Practice Address - Street 1:1919 7TH AVE S
Practice Address - Street 2:ROOM 538
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-934-2340
Practice Address - Fax:205-975-2883
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL48631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice