Individual
BRENT EDGEWORTH BOYETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, DO
Contact information
Practice address
2131 MILITARY ST S, HAMILTON, AL 35570-6651
(205) 921-5556
(205) 921-5595
Mailing address
2131 MILITARY ST S, HAMILTON, AL 35570-6651
(205) 921-0893
(205) 921-6723
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4622
AL
207Q00000X
Family Medicine Physician
Primary
DO654
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009981160
—
AL
Enumeration date
10/19/2006
Last updated
08/24/2011
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