Individual
DR. GIBSON O
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2150 HIGHWAY 54 S, ALAMOGORDO, NM 88310-7330
(575) 443-8133
(575) 443-8055
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0024099
TX
122300000X
Dentist
053883
NY
122300000X
Dentist
Primary
DD4194
NM
Other
Enumeration date
07/21/2008
Last updated
04/08/2021
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