Organization
JENNIFER H. PRUITT DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A. PRUITT DMD (PERSONAL REPRESENTATIVE OF ESTATE)
(256) 927-2600
Entity
Organization
Contact information
Practice address
6118 MCCLELLAN BLVD, ANNISTON, AL 36206-8403
(256) 820-4821
(256) 820-2219
Mailing address
6118 MCCLELLAN BLVD, ANNISTON, AL 36206-8403
(256) 820-4821
(256) 820-2219
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5219
AL
Other
Enumeration date
09/26/2008
Last updated
09/26/2008
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