Provider First Line Business Practice Location Address:
1919 7TH AVE S
Provider Second Line Business Practice Location Address:
UAB SCHOOL OF DENTISTRY SDB 537
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:
205-934-2340
Provider Business Practice Location Address Fax Number:
205-934-7899
Provider Enumeration Date:
11/20/2006