Individual
DR. BARRY FRANK BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6475 SPANISH FORT BLVD, SUITE H, SPANISH FORT, AL 36527-9406
(251) 654-1563
Mailing address
PO BOX 7700, SPANISH FORT, AL 36577-7700
(251) 654-1563
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LND5269
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51515991
BCBS
AL
05
—
631400138
—
AL
Enumeration date
04/04/2006
Last updated
02/21/2012
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