Provider Demographics
NPI:1114041183
Name:KIRKLAND-BRISCOE, GAIL ALICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:ALICIA
Last Name:KIRKLAND-BRISCOE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 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
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN47261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics