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General NPI Number Information
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NPI Number | 1205001518
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Entity Type | Organization
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Legal Business Name | DAVID B. MCGIBBONS ,D.D.S.,LTD
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 6845 ELM ST STE # 500
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City | MC LEAN
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State | VA
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Zip | 22101-6007
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Country | US
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Telephone | 703-356-5330
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Fax | 703-356-7239
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Provider Business Mailing Address
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Address Line | 6845 ELM ST STE # 500
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City | MC LEAN
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State | VA
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Zip | 22101-6007
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Country | US
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Telephone | 703-356-5330
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Fax | 703-356-7239
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Authorized Official
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Title or Position | DENTIST
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Name | DAVID B MCGIBBONS
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Credential | DDS
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Telephone | 703-356-5330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401004264
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License Number State | VA
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