Provider Demographics
NPI:1467861070
Name:GILKES, DEVON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:
Last Name:GILKES
Suffix:
Gender:M
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:HQ DENTAC FORT CAVAZOS
Mailing Address - Street 2:36014 WRATTEN DR ATTN: HEATHER DELLERMAN
Mailing Address - City:FORT CAVAZOS
Mailing Address - State:TX
Mailing Address - Zip Code:76549
Mailing Address - Country:US
Mailing Address - Phone:615-491-2739
Mailing Address - Fax:
Practice Address - Street 1:HQ DENTAC FORT CAVAZOS
Practice Address - Street 2:36014 WRATTEN DR. ATTN: HEATHER DELLERMAN
Practice Address - City:FORT CAVAZOS
Practice Address - State:TX
Practice Address - Zip Code:75644
Practice Address - Country:US
Practice Address - Phone:651-497-2739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60494653122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist