Individual
MINA OH
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
4164 CARMICHAEL RD, MONTGOMERY, AL 36106-3600
(334) 277-2980
Mailing address
1010 BEACON PKWY E UNIT 1121, BIRMINGHAM, AL 35209-3206
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D.007452-C1
AL
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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