Provider Demographics
NPI:1871694794
Name:SITTASON, DAVID BRYANT (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRYANT
Last Name:SITTASON
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:PO BOX 1266
Mailing Address - Street 2:819 HWY 31 NW SUITE A
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640
Mailing Address - Country:US
Mailing Address - Phone:256-773-2233
Mailing Address - Fax:256-773-6244
Practice Address - Street 1:819 HWY 31 NW SUITE A
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640
Practice Address - Country:US
Practice Address - Phone:256-773-2233
Practice Address - Fax:256-773-6244
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL44061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice