Individual
DR. MICHAEL P GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4801 W PETERSON AVE, SUITE 550, CHICAGO, IL 60646-5795
(773) 736-0836
(773) 736-0882
Mailing address
4801 W PETERSON AVE, SUITE 550, CHICAGO, IL 60646-5795
(773) 736-0836
(773) 736-0882
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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