Individual
KEITH EDWARD GIBSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3906 NW 10TH ST, OKLAHOMA CITY, OK 73107-6037
(405) 942-6222
(405) 946-3112
Mailing address
3906 NW 10TH ST, OKLAHOMA CITY, OK 73107-6037
(405) 942-6222
(405) 946-3112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4690
OK
Other
Enumeration date
09/23/2007
Last updated
09/23/2007
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