Provider Demographics
NPI:1194021592
Name:GILMORE, RICHARD FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FRANK
Last Name:GILMORE
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 1:2271 FERNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-6062
Mailing Address - Country:US
Mailing Address - Phone:970-242-1779
Mailing Address - Fax:
Practice Address - Street 1:2271 FERNWOOD CT
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-6062
Practice Address - Country:US
Practice Address - Phone:970-242-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2715122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist