Provider First Line Business Practice Location Address:
1101 JACKSON AVENUE
Provider Second Line Business Practice Location Address:
TUSCALOOSA COUNTY HEALTH DEPT CO DENTAL CLINIC
Provider Business Practice Location Address City Name:
TUSCALOOSA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-391-5416
Provider Business Practice Location Address Fax Number:
205-750-8004
Provider Enumeration Date:
10/12/2006