Benjamin M Pridemore, DDS Valid NPI

Individual provider · Orthodontics and Dentofacial Orthopedics Dentistry · Rome, GA

NPI

1336153592

Type

Individual (Type 1)

Primary specialty

Orthodontics and Dentofacial Orthopedics Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223X0400X

License number

DN007095 (GA)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-07-27

Last updated

2007-07-08