NPI 1104251412

W. Jackson Garner D.M.D

Organisation Exclusive Provider Organization Forestdale, AL

Practice location

Address: 2129 Forestdale Blvd, Forestdale, AL 35214-1523
Phone: (205) 798-6561
Fax: (205) 285-9663

Authorised official

Name: Walter Jackson Garner
Title: Dentist
Phone: (205) 798-6561

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 5113 (AL)

Other Exclusive Provider Organization providers in Alabama →

Registry record

NPI: 1104251412
Entity type: Organization
NPI issued: 5 Sep 2013
Record last updated: 5 Sep 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.