Carl Ross Provenzano, DDS is a student in an organized health care education training program in Birmingham, AL. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Carl Ross Provenzano, DDS NPI is 1548895543. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
625 19TH ST S
BIRMINGHAM, AL
ZIP 35233-900
Phone: (205) 934-4507
The enumeration date for this NPI number is 3/10/2020 and was last updated on 3/10/2020.