Provider First Line Business Practice Location Address:
1919 7TH AVE SOUTH DENTAL FACULTY PRACTICE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35294-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-5470
Provider Business Practice Location Address Fax Number:
205-934-0208
Provider Enumeration Date:
11/08/2006