Individual
DR. GAVIN GIBBS HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
834 CLAREMONT CENTER DRIVE, ELKIN, NC 28621
(336) 835-1212
(336) 835-3149
Mailing address
834 CLAREMONT CENTER DRIVE, ELKIN, NC 28621
(336) 835-1212
(336) 835-3149
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4488
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8993568
—
NC
01
—
93568
HEALTH CHOICE
NC
Enumeration date
07/29/2006
Last updated
07/08/2007
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