Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 5630 | AL |
N | 1223D0001X | Dental Public Health | 5630 | AL |
NPI | 1447418389 |
---|---|
Provider Name | Dr. Ann Marie Ardovino |
First Address | Alabaster, AL 35007-3205 |
Second Address | Alabaster, AL 35007-3205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 24/02/2017 |