Provider Demographics
NPI:1477206738
Name:DEBORAH M. GADILLE DDS, PC
Entity Type:Organization
Organization Name:DEBORAH M. GADILLE DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GADILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-773-0565
Mailing Address - Street 1:2940 BILBRAEL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-8306
Mailing Address - Country:US
Mailing Address - Phone:989-773-9437
Mailing Address - Fax:
Practice Address - Street 1:209 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTPHALIA
Practice Address - State:MI
Practice Address - Zip Code:48894-9801
Practice Address - Country:US
Practice Address - Phone:989-773-0565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental