Individual
DR. DOMINIQUE BACKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3507 OLD MONTGOMERY HWY, BIRMINGHAM, AL 35209-5751
(205) 879-0557
Mailing address
3507 OLD MONTGOMERY HWY, BIRMINGHAM, AL 35209-5751
(205) 879-0557
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5065
AL
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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