Provider Demographics
NPI:1184936031
Name:CONTRATTO, BENJAMIN MATHEAU (DMD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MATHEAU
Last Name:CONTRATTO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5735 BLANFORD ST
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-3404
Mailing Address - Country:US
Mailing Address - Phone:205-305-1703
Mailing Address - Fax:
Practice Address - Street 1:116 COFFEE ST E
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2402
Practice Address - Country:US
Practice Address - Phone:256-362-8511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist