Individual
DR. PHILLIP L FORTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
569 MCCURDY AVE N, RAINSVILLE, AL 35986-4409
(256) 638-7272
(256) 638-7271
Mailing address
PO BOX 2119, RAINSVILLE, AL 35986-2119
(256) 638-7272
(256) 638-7271
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4697
AL
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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