Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 4386 | AL |
NPI | 1043381619 |
---|---|
Provider Name | Dr. Christy Jebeles |
First Address | Trussville, AL 35173-1376 |
Second Address | Trussville, AL 35173-1376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |