Provider Demographics
NPI:1598835514
Name:PEZZEMENTI, MAUREEN LOWERY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:LOWERY
Last Name:PEZZEMENTI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 50TH PL S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-3920
Mailing Address - Country:US
Mailing Address - Phone:205-934-5470
Mailing Address - Fax:205-934-0208
Practice Address - Street 1:1919 7TH AVE SOUTH DENTAL FACULTY PRACTICE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-934-5470
Practice Address - Fax:205-934-0208
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL47311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice