Provider Demographics
NPI:1639547482
Name:GILMAN, ANDRES DANIEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:DANIEL
Last Name:GILMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 LBJ FWY STE 1400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2766
Mailing Address - Country:US
Mailing Address - Phone:972-663-5353
Mailing Address - Fax:972-663-5250
Practice Address - Street 1:3030 LBJ FWY STE 1400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-2766
Practice Address - Country:US
Practice Address - Phone:972-663-5353
Practice Address - Fax:972-663-5250
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310801223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics