Individual
DR. CHRISTOPHER WALTER GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3630 HILL BLVD STE 101, JEFFERSON VALLEY, NY 10535-1503
(914) 245-7100
Mailing address
1510 LEXINGTON AVE APT 9H, NEW YORK, NY 10029-7161
(978) 758-8728
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
059580-1
NY
1223P0221X
Pediatric Dentistry
11815
CT
Other
Enumeration date
03/19/2015
Last updated
07/25/2019
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