Provider Demographics
NPI:1023012465
Name:BILBRO, GEORGE S (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:S
Last Name:BILBRO
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 1:5555 N MESA ST
Mailing Address - Street 2:STE 400
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5424
Mailing Address - Country:US
Mailing Address - Phone:915-581-6673
Mailing Address - Fax:915-581-1062
Practice Address - Street 1:5555 N MESA ST
Practice Address - Street 2:STE 400
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5424
Practice Address - Country:US
Practice Address - Phone:915-581-6673
Practice Address - Fax:915-581-1062
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD11580122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist