Individual
DR. MATTHEW OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
625 19TH ST S, BIRMINGHAM, AL 35233-1900
(205) 934-2552
Mailing address
625 19TH ST S, BIRMINGHAM, AL 35233-1900
(205) 934-2552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6408
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2017
Last updated
03/26/2018
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