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1205094117
PHATTARA GIBBS
LAKELAND, FL
NPI
1205094117
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: FL DN18269)
Enumeration Date
2008-05-28
Last Update Date
2009-11-03
Business Address
DR. PHATTARA GIBBS DMD
4744 S FLORIDA AVE
LAKELAND, FL 33813-2181
Phone number: 863-644-1226
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Mailing Address
DR. PHATTARA GIBBS DMD
5801 S MACDILL AVE UNIT 14
TAMPA, FL 33611-4482
Phone number: 813-368-3984
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