Individual
BILL J GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5089 ELK RIVER RD N, ELKVIEW, WV 25071
(304) 965-1200
(304) 965-6158
Mailing address
PO BOX 9, ELKVIEW, WV 25071
(304) 965-1200
(304) 965-6158
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2220
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135148000
—
WV
Enumeration date
12/19/2006
Last updated
07/08/2007
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