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General NPI Number Information
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NPI Number | 1649787912
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Entity Type | Organization
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Legal Business Name | JUBILEE FAMILY DENTISTRY, LLC
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 6475 JORDAN AVENUE
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City | DAPHNE
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State | AL
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Zip | 36526
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Country | US
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Telephone | 251-626-6450
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Fax |
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Provider Business Mailing Address
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Address Line | 6475 JORDAN RD
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City | DAPHNE
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State | AL
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Zip | 36526-4728
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Country | US
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Telephone | 251-626-6450
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | BIBIANA TELKA BARBERI
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Credential | DMD
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Telephone | 352-665-1916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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