Organization
PHILLIP L FORTNER DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP FORTNER DMD (DENTIST/OWNER)
(256) 638-7272
Entity
Organization
Contact information
Practice address
569 MCCURDY AVE N, RAINSVILLE, AL 35986-4409
(256) 638-7272
(256) 638-7271
Mailing address
161 MASSINGILL DR, RAINSVILLE, AL 35986-5768
(256) 638-7272
(256) 638-7271
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/28/2021
Last updated
12/28/2021
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