| NPI | 1811623770 |
|---|---|
| Doing Business As | BIRMINGHAM ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | SHANEQUE PHILMON Credentialing Manager 501-462-2062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2024-08-22 |