Healthcare Provider Details

I. General information

NPI: 1457872939
Provider Name (Legal Business Name): GIBSON FAMILY DENTISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 GOLDEN SPRINGS RD
ANNISTON AL
36207-6911
US

IV. Provider business mailing address

609 GOLDEN SPRINGS RD
ANNISTON AL
36207-6911
US

V. Phone/Fax

Practice location:
  • Phone: 256-237-0603
  • Fax: 256-237-0908
Mailing address:
  • Phone: 256-237-0603
  • Fax: 256-237-0908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6325
License Number StateAL

VIII. Authorized Official

Name: DR. MORGAN DUFFY GIBSON
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 256-237-0603