Individual
DR. JOHN DOUGLAS BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2410 L AND N DRIVE, SUITE A, HUNTSVILLE, AL 35801
(256) 533-4770
(256) 489-4770
Mailing address
2410 L AND N DRIVE, SUITE A, HUNTSVILLE, AL 35801
(256) 533-4770
(256) 489-4770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4074
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
694058
UNITED CONCORDIA
—
01
—
90431
BLUE CROSS
AL
Enumeration date
11/28/2006
Last updated
07/08/2007
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