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General NPI Number Information
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NPI Number | 1598890725
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Entity Type | Individual
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Provider Name | RUTH PENTON POLSON DMD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 3145 GREEN VALLEY ROAD SUITE 101
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City | VESTANA HILLS
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State | AL
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Zip | 35243
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Country | US
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Telephone | 205-970-7292
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Fax | 205-623-3036
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Provider Business Mailing Address
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Address Line | 3145 GREEN VALLEY ROAD SUITE 101
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City | VESTANA HILLS
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State | AL
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Zip | 35243
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Country | US
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Telephone | 205-970-7292
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Fax | 205-623-3036
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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 | 5186
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License Number State | AL
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