Organization
1917 DENTAL CLINIC
Active
Parent organization
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Authorized official
JACQUISELYN STORY (BUSINESS OFFICE DIRECTOR)
(205) 934-5088
Entity
Organization
Contact information
Practice address
3220 5TH AVE S # 2022, BIRMINGHAM, AL 35222-2309
(205) 975-9842
Mailing address
3220 5TH AVE S # 2022, BIRMINGHAM, AL 35222-2309
(205) 975-9842
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/16/2022
Last updated
05/17/2022
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