Individual
DR. GARY E WIDDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
423 N EASTERN AVE, LV, NV 89101-4026
(702) 382-1244
(702) 382-6506
Mailing address
423 N EASTERN AVE, LV, NV 89101-4026
(702) 382-1244
(702) 382-6506
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2115
NV
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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