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General NPI Number Information
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NPI Number | 1174349047
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Entity Type | Organization
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Legal Business Name | CAHABA VALLEY PEDIATRIC DENTISTRY PC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 141 NARROWS DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-8627
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Country | US
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Telephone | 205-408-8889
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Fax |
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Provider Business Mailing Address
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Address Line | 141 NARROWS DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-8627
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Country | US
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Telephone | 205-408-8889
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Fax |
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Authorized Official
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Title or Position | PAYOR RELATIONS MANAGER
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Name | CASSIE WIETH
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Credential |
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Telephone | 623-267-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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