Provider Demographics
NPI:1952054405
Name:VIBE DENTAL OF HUNTSVILLE PLLC
Entity Type:Organization
Organization Name:VIBE DENTAL OF HUNTSVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-512-1839
Mailing Address - Street 1:1807 UNIVERSITY DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5744
Mailing Address - Country:US
Mailing Address - Phone:256-536-7414
Mailing Address - Fax:
Practice Address - Street 1:1807 UNIVERSITY DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5744
Practice Address - Country:US
Practice Address - Phone:256-536-7414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2565367414OtherPHONE NUMBER