Individual
MAKENNA BRIANNE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
10914 NAGEL CT, LOUISVILLE, KY 40241-4855
(606) 215-9255
Mailing address
10914 NAGEL CT, LOUISVILLE, KY 40241-4855
(606) 215-9255
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
11120
KY
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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