Organization
CPDENTAL, PLLC
Active
Other names
SOUTHPORT FAMILY DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA GIBSON DMD (MEMBER)
(203) 435-1751
Entity
Organization
Contact information
Practice address
10 JOHN ST, SOUTHPORT, CT 06890-1437
(203) 255-5142
(203) 259-5954
Mailing address
10 JOHN ST, SOUTHPORT, CT 06890-1437
(203) 255-5142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
07/20/2020
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