Individual
JENNIFER LOUISE GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
5720 1ST AVE S, BIRMINGHAM, AL 35212-2522
(205) 380-9455
Mailing address
113 KNOLL CREST DR, BIRMINGHAM, AL 35209-6911
(205) 902-3055
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
8900
AL
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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