Provider Demographics
NPI:1235153941
Name:GILMAN, RICHARD S (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:GILMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MCGEE DR STE 121
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6705
Mailing Address - Country:US
Mailing Address - Phone:405-364-4608
Mailing Address - Fax:405-364-3805
Practice Address - Street 1:2500 MCGEE DR STE 121
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6705
Practice Address - Country:US
Practice Address - Phone:405-364-4608
Practice Address - Fax:405-364-3805
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK38081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics