Provider Demographics
NPI:1235781709
Name:S. GIBREE, D.M.D., P.C.
Entity Type:Organization
Organization Name:S. GIBREE, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-540-5100
Mailing Address - Street 1:4008 BRIAN JORDAN PL STE 105
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8337
Mailing Address - Country:US
Mailing Address - Phone:336-822-9557
Mailing Address - Fax:336-803-4067
Practice Address - Street 1:4008 BRIAN JORDAN PL STE 105
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8337
Practice Address - Country:US
Practice Address - Phone:336-218-6806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S. GIBREE, D.M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-15
Last Update Date:2019-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty