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General NPI Number Information
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NPI Number | 1124187083
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Entity Type | Organization
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Legal Business Name | NORTH BIRMINGHAM DENTAL CARE
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 3200 27TH ST N
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City | BIRMINGHAM
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State | AL
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Zip | 35207-4554
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Country | US
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Telephone | 205-324-5130
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Fax | 205-324-5188
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Provider Business Mailing Address
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Address Line | 3200 27TH ST N
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City | BIRMINGHAM
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State | AL
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Zip | 35207-4554
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Country | US
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Telephone | 205-324-5130
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Fax | 205-324-5188
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MARSHALL A WILLIAMS
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Credential | D.D.S.
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Telephone | 205-324-5130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 3811
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License Number State | AL
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