Provider Demographics
NPI:1588817795
Name:RICHARD J. GILL, D.D.S., INC.
Entity Type:Organization
Organization Name:RICHARD J. GILL, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-325-6480
Mailing Address - Street 1:1921 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7001
Mailing Address - Country:US
Mailing Address - Phone:760-325-6480
Mailing Address - Fax:
Practice Address - Street 1:73368 BURSERA WAY
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5729
Practice Address - Country:US
Practice Address - Phone:760-325-6480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty