Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN10332 | GA |
NPI | 1720634769 |
---|---|
Provider Name | Arlene Lester |
First Address | Birmingham, AL 35233 |
Second Address | Birmingham, AL 35233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2019 |
Last Update Date | 15/08/2019 |