Organization
WEST PRINCETON DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA JACKSON BUTLER (OFFICE MANAGER)
(205) 788-2124
Entity
Organization
Contact information
Practice address
859 LOMB AVE SW, BIRMINGHAM, AL 35211-1257
(205) 788-2124
Mailing address
859 LOMB AVE SW, BIRMINGHAM, AL 35211-1257
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700-9799-94
INDIVIDUAL NPI NUMBER
AL
Enumeration date
08/29/2007
Last updated
08/29/2007
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