Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 8034 | AL |
NPI | 1003410879 |
---|---|
Provider Name | Brittney T Debruce |
First Address | Birmingham, AL 35212-2522 |
Second Address | Birmingham, AL 35212-2522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2020 |
Last Update Date | 23/11/2020 |