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General NPI Number Information
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NPI Number | 1679969588
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Entity Type | Organization
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Legal Business Name | BIRMINGHAM ORTHODONTICS
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 3825 LORNA RD SUITE 248
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City | HOOVER
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State | AL
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Zip | 35244-3005
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Country | US
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Telephone | 205-733-2022
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Fax | 205-733-9671
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Provider Business Mailing Address
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Address Line | 3825 LORNA RD SUITE 248
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City | HOOVER
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State | AL
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Zip | 35244-3005
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Country | US
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Telephone | 205-733-2022
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Fax | 205-733-9671
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Authorized Official
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Title or Position | CEO
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Name | MR. BRIAN MCCARTHY
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Credential |
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Telephone | 205-733-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 3871
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License Number State | AL
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