Organization
DOMINIQUE BACKUS LLC
Active
Other names
Orthodontic Associates PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIQUE VIDRINE BACKUS DDS (ORTHODONTIST)
(205) 879-0557
Entity
Organization
Contact information
Practice address
3507 OLD MONTGOMERY HWY, BIRMINGHAM, AL 35209
(205) 879-0557
(205) 879-6611
Mailing address
3507 OLD MONTGOMERY HWY, BIRMINGHAM, AL 35209
(205) 879-0557
(205) 879-6611
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5065
AL
Other
Enumeration date
09/26/2006
Last updated
08/22/2020
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