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General NPI Number Information
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NPI Number | 1417051061
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Entity Type | Individual
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Provider Name | BRETT W BIGELOW DMD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1202 S BROAD ST
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City | SCOTTSBORO
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State | AL
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Zip | 35768-2516
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Country | US
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Telephone | 256-259-5955
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Fax | 256-259-5954
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Provider Business Mailing Address
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Address Line | 1202 SOUTH BROAD ST
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City | SCOTTSBORO
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State | AL
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Zip | 35768
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Country | US
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Telephone | 256-259-5955
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Fax | 256-259-5954
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4762
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License Number State | AL
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