Provider Demographics
NPI:1659714228
Name:GILL, DANIELLE GLADNEICE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:GLADNEICE
Last Name:GILL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:GLADNEICE
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:102 CAMERON DR
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-8912
Mailing Address - Country:US
Mailing Address - Phone:704-718-8989
Mailing Address - Fax:
Practice Address - Street 1:515 WORLEY RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3753
Practice Address - Country:US
Practice Address - Phone:864-714-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344371223S0112X
NC116411223S0112X, 204E00000X
SC98191223S0112X
SC98181223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery