Organization
NORTH JEFFERSON PEDIATRIC DENTISTRY, LLC
Active
Other names
Amy T. Parvin, D.M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SELENA D DEVINE (OFFICE MANAGER)
(205) 631-2240
Entity
Organization
Contact information
Practice address
925 SHARIT AVE, STUITE 113, GARDENDALE, AL 35071-5000
(205) 631-2240
(205) 631-1611
Mailing address
925 SHARIT AVE, STUITE 113, GARDENDALE, AL 35071-5000
(205) 631-2240
(205) 631-1611
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4970
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356891
UCCI
AL
01
—
51531288
BCBS OF ALABAMA
AL
Enumeration date
02/12/2007
Last updated
08/22/2020
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