Individual
DR. DOUGLAS BRIAN GIBBONS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1101 MEDICAL ARTS AVE NE, SANDIA MEDICAL PARK BLDG. # 1, ALBUQUERQUE, NM 87102-2706
(505) 842-0808
(505) 842-1165
Mailing address
1101 MEDICAL ARTS AVE NE, SANDIA MEDICAL PARK BLDG. # 1, ALBUQUERQUE, NM 87102-2706
(505) 842-0808
(505) 842-1165
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD1483
NM
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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