| Organization Name: | W.SIDNEY GIBSON, DDS, PA |
| NPI Number: | 1013193465 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WENDY GRICE BULLARD (RECEPTIONIST) |
| Mailing Address: | 904 Spivey Rd Whiteville |
| State: | NC US |
| Postal Code: | 284722915 |
| Phone Number: | 9106427741 |
| Fax Number: | 9106402373 |
| NPI Enumeration Date: | 01/16/2008 |
| NPI Last Update Date: | 01/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 3921 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |