Provider Demographics
NPI:1932221959
Name:GARDNER, JAMES STEVE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEVE
Last Name:GARDNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MARSHEUTZ AVE SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4528
Mailing Address - Country:US
Mailing Address - Phone:256-533-1435
Mailing Address - Fax:256-534-0779
Practice Address - Street 1:107 MARSHEUTZ AVE SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4528
Practice Address - Country:US
Practice Address - Phone:256-533-1435
Practice Address - Fax:256-534-0779
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4480122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist