Provider Demographics
NPI:1689888372
Name:WOOD, DIANA PEARIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:PEARIS
Last Name:WOOD
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 1:3020 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-1303
Mailing Address - Country:US
Mailing Address - Phone:205-967-9211
Mailing Address - Fax:
Practice Address - Street 1:502 MONTGOMERY HWY
Practice Address - Street 2:SUITE 201
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1862
Practice Address - Country:US
Practice Address - Phone:205-822-2808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL35611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice