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General NPI Number Information
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NPI Number | 1487084729
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Entity Type | Organization
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Legal Business Name | BLACK WARRIOR DENTAL CENTER
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Dates
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Enumeration Date | 11/23/2013
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Last Update Date | 11/23/2013
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Provider Practice Location Address
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Address Line | 535 JACK WARNER PKWY NE SUITE J-1
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5751
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Country | US
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Telephone | 205-764-1529
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Fax |
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Provider Business Mailing Address
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Address Line | 535 JACK WARNER PKWY NE SUITE J-1
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5751
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Country | US
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Telephone | 205-764-1529
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ADRIAN K ROWE
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Credential | DDS
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Telephone | 205-764-1529
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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 | 6052
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License Number State | AL
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