University of Alabama at Birmingham

NPI #1053182055 in Dothan, Alabama

Provider Information

NPI Number: 1053182055
Entity Type: Organization
Organization Name: University of Alabama at Birmingham
Subpart: Yes (part of a larger organization)
Parent Organization: UNIVERSITY OF ALABAMA AT BIRMINGHAM
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 10, 2024
Last Updated: Jan 10, 2024

Practice Location

Address: 2826 ROSS CLARK CIR STE 305
City: Dothan
State: Alabama
ZIP Code: 36301-2017
Phone: (334) 305-3290

Authorized Official

Name: JACQUISELYN STORY
Title: DIRECTOR BUSINESS OFFICE
Phone: (205) 934-5088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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