NPI 1609474014

Jennifer Louise Gough, RDH

Practitioner Dental Hygienist Birmingham, AL

Practice location

Address: 5720 1st Ave S, Birmingham, AL 35212-2522
Phone: (205) 380-9455
Mailing address: 113 Knoll Crest Dr, Birmingham, AL 35209-6911

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 8900 (AL)

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Registry record

NPI: 1609474014
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Oct 2020
Record last updated: 16 Oct 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.