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Individual

DR. KEVIN GIBBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
137 RADIO CITY DR, STE C, NORTH PEKIN, IL 61554-1569
(773) 407-8304
Mailing address
PO BOX 268111, CHICAGO, IL 60626-8111

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019021806
IL

Other

Enumeration date
09/29/2015
Last updated
09/29/2015
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