Individual
DANIEL FORREST FONTENOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
23678 US HIGHWAY 98, FAIRHOPE, AL 36532-3336
(251) 928-8770
Mailing address
1919 7TH AVE S, BIRMINGHAM, AL 35233-2005
(205) 934-3387
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D.007324-C1
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2023
Last updated
11/12/2024
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