Individual
JOHN JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
486 ANDREWS AVE, OZARK, AL 36360-3806
(334) 774-5952
(334) 445-9006
Mailing address
PO BOX 1909, 486 ANDREWS AVENUE, OZARK, AL 36361-1909
(334) 774-5952
(334) 445-9006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5080
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009957325
—
AL
01
—
515-05271
BCBS OF AL PROVIDER ID
AL
Enumeration date
10/10/2006
Last updated
06/28/2022
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