Provider First Line Business Practice Location Address:
1919 7TH AVENUE SOUTH
Provider Second Line Business Practice Location Address:
UAB SCHOOL OF DENTISTRY
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35294-0007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-975-1924
Provider Business Practice Location Address Fax Number:
205-975-2883
Provider Enumeration Date:
10/12/2006