Organization
WISE OMFS
Active
Other names
WISE OMFS
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA JACKSON (REVENUE CYCLE MANAGER)
(205) 919-1750
Entity
Organization
Contact information
Practice address
5750 BENTLEY WAY, TRUSSVILLE, AL 35173-6700
(205) 665-5144
Mailing address
1990 SOUTHWOOD RD, VESTAVIA HILLS, AL 35216-1422
(205) 823-1473
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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