Organization
DOMINIQUE BACKUS LLC
Active
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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