Healthcare Provider Details

I. General information

NPI: 1568624203
Provider Name (Legal Business Name): JAMES I GILBERT III DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 N MONROE AVENUE
COVINGTON VA
24426
US

IV. Provider business mailing address

229 N MONROE AVENUE
COVINGTON VA
24426
US

V. Phone/Fax

Practice location:
  • Phone: 540-962-1709
  • Fax: 540-962-4854
Mailing address:
  • Phone: 540-962-1709
  • Fax: 540-962-4854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateVA

VIII. Authorized Official

Name: MRS. MARTHA W GILBERT
Title or Position: SECRETARY TREASURER
Credential:
Phone: 540-962-1709