Organization
BIVONA FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JACOB BIVONA DMD (DENTIST)
(205) 387-8888
Entity
Organization
Contact information
Practice address
1206 HIGHWAY 78 E, JASPER, AL 35501-3939
(205) 387-8888
(205) 387-8118
Mailing address
1206 HIGHWAY 78 E, JASPER, AL 35501-3939
(205) 387-8888
(205) 387-8118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5848
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142151
—
AL
Enumeration date
11/05/2012
Last updated
11/05/2012
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