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Individual

DR. JAMES DAVID GIPSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS MD

Contact information

Practice address
1103 E MONTCLAIR ST, SUITE 100, SPRINGFIELD, MO 65807-5076
(417) 887-8800
(417) 887-6265
Mailing address
1103 E MONTCLAIR ST, SUITE 100, SPRINGFIELD, MO 65807-5076
(417) 887-8800
(417) 887-6265

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
015813D
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107914
B CHOICE
01
11827
BC/S DENTAL
01
967720
UNITED CONCORDIA
Enumeration date
09/15/2005
Last updated
07/08/2007
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