Individual
DR. GARY BRUCE WOODCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
516 EAST NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1560
(505) 722-1563
Mailing address
P.O. BOX 1337, GALLUP, NM 87305-1337
(505) 722-1560
(505) 722-1563
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
25656
CA
Other
Enumeration date
02/07/2007
Last updated
10/31/2011
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