Provider Demographics
NPI:1730220955
Name:DENTREMONT, FRANKLIN ALCIDE JR (DMD)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:ALCIDE
Last Name:DENTREMONT
Suffix:JR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:3501 GULF SHORES PKWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-5710
Mailing Address - Country:US
Mailing Address - Phone:251-943-0004
Mailing Address - Fax:844-208-8385
Practice Address - Street 1:3501 GULF SHORES PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-5710
Practice Address - Country:US
Practice Address - Phone:251-943-0004
Practice Address - Fax:844-208-8385
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL40211223G0001X
ME28341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-37567OtherBLUE CROSS BLUE SHIELD ALABAMA
AL149832Medicaid
AL2898361OtherUNITED CONCORDIA OF ALABAMA