Provider Demographics
NPI:1003182502
Name:GAIL A. KIRKLAND-BRISCOE, DDS PC
Entity Type:Organization
Organization Name:GAIL A. KIRKLAND-BRISCOE, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:KIRKLAND-BRISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:202-526-4060
Mailing Address - Street 1:3012 18TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2458
Mailing Address - Country:US
Mailing Address - Phone:202-526-4060
Mailing Address - Fax:202-526-4065
Practice Address - Street 1:3012 18TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2458
Practice Address - Country:US
Practice Address - Phone:202-526-4060
Practice Address - Fax:202-526-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN47261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty