Provider Demographics
NPI:1023247632
Name:ROSS BRIDGE FAMILY & COSMETIC DENTISTRY
Entity type:Organization
Organization Name:ROSS BRIDGE FAMILY & COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER WITH DR. GIA M. BROTHERS
Authorized Official - Prefix:DR
Authorized Official - First Name:M.
Authorized Official - Middle Name:JAMIE
Authorized Official - Last Name:MOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-821-5633
Mailing Address - Street 1:2201 GRAND AVE
Mailing Address - Street 2:SUITE #113
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-6102
Mailing Address - Country:US
Mailing Address - Phone:205-945-3035
Mailing Address - Fax:
Practice Address - Street 1:2201 GRAND AVE
Practice Address - Street 2:SUITE #113
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-6102
Practice Address - Country:US
Practice Address - Phone:205-945-3035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty