Wallace, Martha Cochran
Wallace, Martha Cochran is an individual health care provider with primary practice located at 1400 6Th Ave S , Birmingham AL 35233-1502. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Wallace, Martha Cochran can be contacted via phone (205) 930-1015.Contact Information
Primary practice address
1400 6Th Ave S
Birmingham AL 35233-1502
Phone: (205) 930-1015
Fax: (205) 930-1448
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3030 | Alabama |
Profile Details
| NPI number | 1639172158 |
|---|---|
| LBN Legal business name | Wallace, Martha Cochran |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2005 |
| Last updated | Jan 5th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639172158 | NPPES |
| Alabama | MEDICAID | 103678 | |
| Alabama | MEDICAID | 103676 | |
| Alabama | MEDICAID | 1639172158 | |
| Alabama | MEDICAID | 103546 | |
| Alabama | Other | 510-40457 | |
| Alabama | Other | 510-40458 | |
| Alabama | Other | 510-40459 | |
| Alabama | MEDICAID | 103578 | |
| Alabama | Other | 510-40460 |
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