| 1917 Dental Clinic | |
|
3220 5th Ave S # 2022 Birmingham AL 35222-2309 | |
| (205) 975-9842 | |
| Not Available |
| Full Name | 1917 Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 3220 5th Ave S # 2022, Birmingham, Alabama |
| Authorized Official Name and Position | Jacquiselyn Story (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Contact | 2059345088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1917 Dental Clinic 3220 5th Ave S # 2022 Birmingham AL 35222-2309 Ph: (205) 975-9842 | 1917 Dental Clinic 3220 5th Ave S # 2022 Birmingham AL 35222-2309 Ph: (205) 975-9842 |
| NPI Number | 1093452633 |
|---|---|
| Provider Enumeration Date | 05/16/2022 |
| Last Update Date | 05/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093452633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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