Healthcare Provider Details

I. General information

NPI: 1528592227
Provider Name (Legal Business Name): CLAIRE WOOD D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 07/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6807 TATTERSAL WAY
BIRMINGHAM AL
35242-4237
US

IV. Provider business mailing address

117 EDGEMONT DR
HOMEWOOD AL
35209-6901
US

V. Phone/Fax

Practice location:
  • Phone: 205-545-8001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6467
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: