Individual
MS. JAN MARIE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BLDG 128 CHAFFEE RD, US ARMY DENTAL ACTIVITY, ATTN: DENTAC HEADQUEARTERS, FORT BLISS, TX 79916
(915) 742-6001
Mailing address
215 SHERIDAN RD, EL PASO, TX 79906-3803
(253) 283-9106
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6445
WA
Other
Enumeration date
04/14/2006
Last updated
06/16/2016
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