Individual
DINO C JACOVIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3142 CUHABA HEIGHTS RD, VESTAVIA, AL 35243
(205) 970-1866
(205) 970-1896
Mailing address
3142 CUHABA HEIGHTS RD, VESTAVIA, AL 35243
(205) 970-1866
(205) 970-1896
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4166
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1303418
UNITED CONCORDIA
AL
01
—
40992
BC BS OF AL
AL
Enumeration date
09/06/2007
Last updated
09/06/2007
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