Organization
MICHAEL PRUITT DBA JENNIFER H. PRUITT, D.M.D.
Active
Other names
Jennifer H. Pruitt, D.M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A. PRUITT D.M.D. (PERSONAL REPRESENATIVE OF ESTATE)
(256) 820-4821
Entity
Organization
Contact information
Practice address
6118 MCCLELLAN BLVD, ANNISTON, AL 36206-8403
(256) 820-4821
Mailing address
6118 MCCLELLAN BLVD., ANNISTON, AL 36206
(256) 820-4821
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5161
AL
Other
Enumeration date
03/16/2009
Last updated
03/16/2009
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