Individual
DR. JILL EMILY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3929 S HIGHWAY 14, GREENVILLE, SC 29615-6138
(423) 715-8413
Mailing address
3929 S HIGHWAY 14, GREENVILLE, SC 29615-6138
(423) 715-8413
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10587
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2018
Last updated
08/23/2023
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