Provider Demographics
NPI:1871886325
Name:JILL BARTON GAMOTIS, DMD, LLC
Entity type:Organization
Organization Name:JILL BARTON GAMOTIS, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:GAMOTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-384-6000
Mailing Address - Street 1:20 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3425
Mailing Address - Country:US
Mailing Address - Phone:205-384-6000
Mailing Address - Fax:205-384-6024
Practice Address - Street 1:20 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3425
Practice Address - Country:US
Practice Address - Phone:205-384-6000
Practice Address - Fax:205-384-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL49001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty