Organization
JEFFERSON COUNTY BOARD OF HEALTH
Active
Other names
Eastern Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SHEWANDA CLARK (REVENUE INTEGRITY SUPERVISOR)
(205) 558-2158
Entity
Organization
Contact information
Practice address
601 WEST BLVD, BIRMINGHAM, AL 35206-1300
(205) 510-3405
(205) 510-3474
Mailing address
PO BOX 2648, BIRMINGHAM, AL 35202-2648
(205) 510-3405
(205) 510-3474
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529917440
—
AL
Enumeration date
11/28/2006
Last updated
02/12/2019
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