| Alabama Oral And Facial Surgery Llc | |
|
2290 Valleydale Road Suite 100 Birmingham AL 35244-2011 | |
| (205) 682-1099 | |
| (205) 403-7383 |
| Full Name | Alabama Oral And Facial Surgery Llc |
|---|---|
| Speciality | Dentist |
| Location | 2290 Valleydale Road, Birmingham, Alabama |
| Authorized Official Name and Position | Henry E Mckay (MEMBER) |
| Authorized Official Contact | 2056821099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alabama Oral And Facial Surgery Llc 2290 Valleydale Road Suite 100 Birmingham AL 35244-2011 Ph: (205) 682-1099 | Alabama Oral And Facial Surgery Llc 2290 Valleydale Road Suite 100 Birmingham AL 35244-2011 Ph: (205) 682-1099 |
| NPI Number | 1831433556 |
|---|---|
| Provider Enumeration Date | 11/19/2012 |
| Last Update Date | 12/04/2012 |
| Medicare PECOS PAC ID | 8123272598 |
|---|---|
| Medicare Enrollment ID | O20130212000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831433556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4649 (Alabama) | Primary |
| Provider Name | Walter Harris Wilson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1407267321 PECOS PAC ID: 1658597000 Enrollment ID: I20201027001641 |
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