Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 5418 | AL |
NPI | 1063655082 |
---|---|
Provider Name | Dr. Cranford Shane Langley |
First Address | Daphne, AL 36526-4728 |
Second Address | Daphne, AL 36526-4728 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2009 |
Last Update Date | 07/04/2009 |