Organization
CARDINAL DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WORTHINGTON DMD (OWNER)
(334) 347-6456
Entity
Organization
Contact information
Practice address
442 GLOVER AVE, ENTERPRISE, AL 36330
(334) 347-6456
(334) 393-3817
Mailing address
P.O. BOX 311870, ENTERPRISE, AL 36331
(334) 347-6456
(334) 393-3817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5323
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1839862
UNITED CONCORDIA
AL
Enumeration date
03/23/2007
Last updated
08/22/2020
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