Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 6265 C1 | AL |
NPI | 1063874931 |
---|---|
Provider Name | Dr. Danielle Gilbert |
First Address | Birmingham, AL 35242-8093 |
Second Address | Birmingham, AL 35242-8093 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 22/03/2016 |