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HOLTON DEATHERAGE

Dentist

NPI: 1417534116Individual

Specialties, Licenses & Credentials

Student in an Organized Health Care Education/Training Program

Code: 390200000X

DentistPrimary

Dentist

Code: 122300000X

D-0007102-C1(AL)

Contact & Hours

Address
1919 7TH AVE S
BIRMINGHAM, AL 35233

Quick Facts

NPI
1417534116
Entity Type
Individual
Gender
Male
Medicare
Not confirmed
Specialties
2
Locations
1

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