| NPI | 1578692372 |
|---|---|
| Other Name | BIRMINGHAM EASTERN FAMILY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | ADOLPHUS MYRON JACKSON Dentist 205-836-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AL 4492) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL 3138) |
| 1223G0001X Dentist, General Practice (Licence: AL 3679) | |
| 1223G0001X Dentist, General Practice (Licence: AL 4065) | |
| 1223G0001X Dentist, General Practice (Licence: AL 5423) | |
| 1223P0700X Dentist, Prosthodontics (Licence: AL 4394) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |