Individual
DR. BRANDON GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13020 PACIFIC PROMENADE UNIT 315, PLAYA VISTA, CA 90094-4019
(201) 988-4541
Mailing address
13020 PACIFIC PROMENADE UNIT 315, PLAYA VISTA, CA 90094-4019
(201) 988-4541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
108336
CA
Other
Enumeration date
11/01/2022
Last updated
12/06/2022
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