Provider Demographics
NPI:1376564930
Name:GILSON, KATE COLLEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:COLLEEN
Last Name:GILSON
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 1:3118 ROLLING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1356
Mailing Address - Country:US
Mailing Address - Phone:262-522-0264
Mailing Address - Fax:
Practice Address - Street 1:1600 SUMMIT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3236
Practice Address - Country:US
Practice Address - Phone:262-542-0431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5213-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice