James Donald Gilliam, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Noble, OK

NPI

1104949767

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

4106 (OK)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-04-09

Last updated

2007-07-08