Individual
IRADJ SOOUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2000 6TH AVE S, BIRMINGHAM, AL 35233-2110
(205) 934-9999
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07003384
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000005978
—
AL
01
—
05978
BLUE CROSS
AL
01
—
608346
UNITED CONCORDIA
—
Enumeration date
03/15/2007
Last updated
09/28/2016
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