Provider Demographics
NPI:1528738549
Name:ABENOJA ORTHODONTICS LLC
Entity type:Organization
Organization Name:ABENOJA ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:KNOX
Authorized Official - Last Name:ABENOJA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:205-647-7811
Mailing Address - Street 1:211 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180-1346
Mailing Address - Country:US
Mailing Address - Phone:205-647-7811
Mailing Address - Fax:205-647-7844
Practice Address - Street 1:211 MAIN ST N
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-1346
Practice Address - Country:US
Practice Address - Phone:205-647-7811
Practice Address - Fax:205-647-7844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental