Provider Demographics
NPI:1366514770
Name:GIBA, DENNIS J (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:GIBA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12111 SPRING CYPRESS RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8244
Mailing Address - Country:US
Mailing Address - Phone:281-251-3070
Mailing Address - Fax:281-251-8091
Practice Address - Street 1:12111 SPRING CYPRESS RD
Practice Address - Street 2:SUITE E
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8244
Practice Address - Country:US
Practice Address - Phone:281-251-3070
Practice Address - Fax:281-251-8091
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice