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DR. JORDAN BARRY BENTON D.M.D.

Orthodontics and Dentofacial Orthopedics >> Dentist >> Dental Providers

Registrant NPI Number: 1477900363

Individual Registrant:
DR. JORDAN BARRY BENTON D.M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1703 LEIGHTON AVE  ANNISTON, AL 36207-3832 US
Tel: 256-237-1537  Fax: --

Contact information for business:
1703 LEIGHTON AVE  ANNISTON, AL 36207-3832 US
Tel: --  Fax: --

Registration Information:
NPI: 1477900363
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223X0400XDental Providers
Dentist
Orthodontics and Dentofacial Orthopedics
ALD.0006122-C1

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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