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General NPI Number Information
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NPI Number | 1598010555
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Entity Type | Individual
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Provider Name | KRISTEN RENEE BENTLEY D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 1700 6TH AVE N
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City | BESSEMER
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State | AL
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Zip | 35020-4849
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Country | US
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Telephone | 205-434-2031
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Fax |
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Provider Business Mailing Address
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Address Line | 2204 RIDGEMONT DR
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City | BIRMINGHAM
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State | AL
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Zip | 35244-1220
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Country | US
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Telephone | 615-210-3833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5050 C1
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License Number State | AL
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