| NPI | 1275721086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM B GIBSON CEO 606-487-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 7055) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |