Individual
DR. THOMAS J GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
701 S MAIN ST, WESTBY, WI 54667
(608) 634-3978
(608) 634-6205
Mailing address
701 S MAIN ST, WESTBY, WI 54667
(608) 634-3978
(608) 634-6205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3144
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33455700
—
WI
Enumeration date
04/22/2008
Last updated
04/22/2008
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