Individual
DR. GRADY A GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
701 OVERTON ST, NEWPORT, KY 41071-2064
(859) 581-1400
(859) 581-0126
Mailing address
701 OVERTON ST, NEWPORT, KY 41071-2064
(859) 581-1400
(859) 581-0126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5087
KY
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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