Provider Demographics
NPI:1619083623
Name:GILMAN, DENNIS HARTLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:HARTLEY
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 1:3253 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3649
Mailing Address - Country:US
Mailing Address - Phone:516-764-2203
Mailing Address - Fax:516-764-7020
Practice Address - Street 1:3253 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3649
Practice Address - Country:US
Practice Address - Phone:516-764-2203
Practice Address - Fax:516-764-7020
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31751122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist