| Richard S Gillum Inc Pc | |
|
1259 N State Road 135 Suite E Greenwood IN 46142-1033 | |
| (317) 888-7576 | |
| (317) 888-0047 |
| Full Name | Richard S Gillum Inc Pc |
|---|---|
| Speciality | Dentist |
| Location | 1259 N State Road 135, Greenwood, Indiana |
| Authorized Official Name and Position | Shelley D Gillum (OFFICE MANAGER) |
| Authorized Official Contact | 3178887576 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard S Gillum Inc Pc 1259 N State Road 135 Suite E Greenwood IN 46142-1033 Ph: (317) 888-7576 | Richard S Gillum Inc Pc 1259 N State Road 135 Suite E Greenwood IN 46142-1033 Ph: (317) 888-7576 |
| NPI Number | 1639467913 |
|---|---|
| Provider Enumeration Date | 07/20/2011 |
| Last Update Date | 05/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639467913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12008573 (Indiana) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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Edward Garry Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 W County Line Rd, Suite A, Greenwood, IN 46142 Phone: 317-865-3733 Fax: 317-865-3740 | |
Olive Branch Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2826 S State Road 135 Ste C, Greenwood, IN 46143 Phone: 317-743-7777 Fax: 317-854-6577 | |
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