Provider Demographics
NPI:1497504245
Name:GILBERT-HYMA, CALLIE (DMD)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:GILBERT-HYMA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:694 DREW RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-6316
Mailing Address - Country:US
Mailing Address - Phone:334-596-9799
Mailing Address - Fax:
Practice Address - Street 1:107 PROFESSIONAL LN
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-3875
Practice Address - Country:US
Practice Address - Phone:334-596-9799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.007300-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist