Provider Demographics
NPI:1407211766
Name:JULIA T. GILDON, D.D.S., PA
Entity Type:Organization
Organization Name:JULIA T. GILDON, D.D.S., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-664-5615
Mailing Address - Street 1:5 VAN CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-5211
Mailing Address - Country:US
Mailing Address - Phone:501-664-5615
Mailing Address - Fax:501-664-9118
Practice Address - Street 1:5 VAN CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-5211
Practice Address - Country:US
Practice Address - Phone:501-664-5615
Practice Address - Fax:501-664-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR36301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty