Provider Demographics
NPI:1417182155
Name:GILLETTE DENTAL P.C.
Entity Type:Organization
Organization Name:GILLETTE DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-682-3353
Mailing Address - Street 1:301 RICHARDS AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3632
Mailing Address - Country:US
Mailing Address - Phone:307-682-3353
Mailing Address - Fax:307-687-2861
Practice Address - Street 1:301 RICHARDS AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3632
Practice Address - Country:US
Practice Address - Phone:307-682-3353
Practice Address - Fax:307-687-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental