Provider Demographics
NPI:1407079619
Name:WOOLHISER, GAIL A (DDS)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:A
Last Name:WOOLHISER
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 1:916 WASHINGTON
Mailing Address - Street 2:SUITE 224
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708
Mailing Address - Country:US
Mailing Address - Phone:989-894-1122
Mailing Address - Fax:989-894-2626
Practice Address - Street 1:916 WASHINGTON
Practice Address - Street 2:SUITE 224
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708
Practice Address - Country:US
Practice Address - Phone:989-894-1122
Practice Address - Fax:989-894-2626
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010167191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics