Organization
KUNTAL S PANDIT DMD PC
Active
Other names
Oneonta Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGETTE MARIE BLACKWOOD (OFFICE MANAGER)
(205) 625-4384
Entity
Organization
Contact information
Practice address
28425 STATE HIGHWAY 75, ONEONTA, AL 35121-1657
(205) 625-4384
(205) 625-4737
Mailing address
28425 STATE HIGHWAY 75, ONEONTA, AL 35121-1657
(205) 625-4384
(205) 625-4737
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
353978
COMPBEN ID
—
01
—
51077759
BLUE CROSS PROVIDER #
AL
05
—
529916600
—
AL
01
—
577227
UNITED CONCORDIA PROVIDER
—
Enumeration date
03/19/2007
Last updated
03/09/2020
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