NPI | 1770011082 |
---|---|
Former Legal Business Name | JOHN B BENTON JR DDS PC |
Entity Type | Organization |
Authorized Contact | JORDAN BARRY BENTON Doctor/ Owner 256-239-5406 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL 0006122-C) |
Enumeration Date | 2017-05-31 |
Last Update Date | 2022-07-21 |