Individual
LEO K JERNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
100 W 1ST AVE, 1 PROFESSIONAL PK, GULF SHORES, AL 36542-6452
(251) 968-7170
Mailing address
PO BOX 493, GULF SHORES, AL 36547-0493
(251) 968-7170
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AL3256
AL
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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