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1174730287
REX SHANNON GIBSON
BEND, OR
NPI
1174730287
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: OR D7724)
Enumeration Date
2007-05-17
Last Update Date
2008-01-15
Business Address
Dr. REX SHANNON GIBSON D.D.S
1245 SE 3RD ST STE #A-1
BEND, OR 97702-2161
Phone number: 541-318-5688
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Mailing Address
Dr. REX SHANNON GIBSON D.D.S
63870 JOHNSON RD
BEND, OR 97701-5218
Phone number: 541-318-5688
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