Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 4110 | AL |
NPI | 1225127780 |
---|---|
Provider Name | Leonard Anthony Mueninghoff |
First Address | Birmingham, AL 35242-3045 |
Second Address | Birmingham, AL 35294-0007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |