Provider Demographics
NPI:1225173214
Name:BISHOP, WILLIAM MOSS (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MOSS
Last Name:BISHOP
Suffix:
Gender:M
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:2045 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:SUITE 21
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6874
Mailing Address - Country:US
Mailing Address - Phone:205-870-0892
Mailing Address - Fax:205-870-0894
Practice Address - Street 1:2045 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 21
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6874
Practice Address - Country:US
Practice Address - Phone:205-870-0892
Practice Address - Fax:205-870-0894
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL28381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51090465OtherBCBS OF ALABAMA