Provider Demographics
NPI:1518005925
Name:GILMAN, CHANDLER ROBBINS (DDS)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:ROBBINS
Last Name:GILMAN
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 1:1496 S ST FRANCIS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4038
Mailing Address - Country:US
Mailing Address - Phone:505-982-4317
Mailing Address - Fax:505-982-8663
Practice Address - Street 1:1496 S ST FRANCIS DRIVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4038
Practice Address - Country:US
Practice Address - Phone:505-982-4317
Practice Address - Fax:505-982-8663
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD10311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice