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Individual

ROBERT TERRELL UNDERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1038 MT. OLIVE ROAD, GARDENDALE, AL 35071-3443
(205) 631-8066
(205) 631-8021
Mailing address
1038 MT. OLIVE ROAD, GARDENDALE, AL 35071-3443
(205) 631-8066
(205) 631-8021

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4885
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51096265
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/17/2006
Last updated
07/08/2007
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