Organization
ETHERTON FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ANTHONY ETHERTON DMD (PRESIDENT)
(334) 756-4178
Entity
Organization
Contact information
Practice address
6 MEDICAL PARK, VALLEY, AL 36854-3665
(334) 756-4178
(334) 756-5884
Mailing address
6 MEDICAL PARK, VALLEY, AL 36854-3665
(334) 756-4178
(334) 756-5884
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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