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General NPI Number Information
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NPI Number | 1144689118
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Entity Type | Organization
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Legal Business Name | GILBERT ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 100 HEATHERBROOKE PARK DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-8093
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Country | US
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Telephone | 205-991-9545
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Fax | 205-991-9549
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Provider Business Mailing Address
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Address Line | 100 HEATHERBROOKE PARK DR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-8093
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Country | US
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Telephone | 205-991-9545
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Fax | 205-991-9549
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIELLE WIGGINS GILBERT
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Credential | D.M.D
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Telephone | 205-991-9545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6265C1
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License Number State | AL
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