Organization
UNIVERSITY OF ALABAMA AT BIRMINGHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANICE G. JACKSON D.M.D. (PEDIATRIC DENTISTRY PROGRAM DIRECTO)
(205) 934-1134
Entity
Organization
Contact information
Practice address
1919 7TH AVE S, SDB ROOM 311, BIRMINGHAM, AL 35294-0007
(205) 934-7016
Mailing address
1919 7TH AVE S, SDB ROOM 311, BIRMINGHAM, AL 35233-2005
(205) 934-7016
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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