Gibson Dental LLC

NPI #1073963625 in Madison, Alabama

Provider Information

NPI Number: 1073963625
Entity Type: Organization
Organization Name: Gibson Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 14, 2016
Last Updated: Jun 14, 2016

Practice Location

Address: 10871 COUNTY LINE RD
Address 2: SUITE A
City: Madison
State: Alabama
ZIP Code: 35758-3667
Phone: (256) 724-3530

Authorized Official

Name: DR. MATT GIBSON
Title: DENTIST
Phone: (256) 724-3530

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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