MS. Jan Marie Gibson

NPI #1417911496 in Fort Bliss, Texas

Provider Information

NPI Number: 1417911496
Entity Type: Individual
Name: MS. Jan Marie Gibson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Enumeration Date: Apr 14, 2006
Last Updated: Jun 16, 2016

Practice Location

Address: BLDG 128 CHAFFEE RD, US ARMY DENTAL ACTIVITY
Address 2: ATTN: DENTAC HEADQUEARTERS
City: Fort Bliss
State: Texas
ZIP Code: 79916
Phone: (915) 742-6001

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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