Provider Demographics
NPI:1700832904
Name:KILGORE, DEBORAH P (DDS)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:P
Last Name:KILGORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2212
Mailing Address - Country:US
Mailing Address - Phone:252-637-1919
Mailing Address - Fax:252-637-3317
Practice Address - Street 1:1312 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2212
Practice Address - Country:US
Practice Address - Phone:252-637-1919
Practice Address - Fax:252-637-3317
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC62551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC899491AMedicaid
NC9491AOtherBCBS OF NC