Provider Demographics
NPI:1194165019
Name:REBECCA D PITNER DMD PC
Entity type:Organization
Organization Name:REBECCA D PITNER DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PITNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-426-2644
Mailing Address - Street 1:895 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-6033
Mailing Address - Country:US
Mailing Address - Phone:205-426-2644
Mailing Address - Fax:205-424-8778
Practice Address - Street 1:895 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-6033
Practice Address - Country:US
Practice Address - Phone:205-426-2644
Practice Address - Fax:205-424-8778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5626122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty