Provider Demographics
NPI:1730465915
Name:GILMAN, MICHAEL SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
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 1:5220 NEIL RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6505
Mailing Address - Country:US
Mailing Address - Phone:775-826-7883
Mailing Address - Fax:775-826-4934
Practice Address - Street 1:5220 NEIL RD
Practice Address - Street 2:SUITE 210
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6505
Practice Address - Country:US
Practice Address - Phone:775-826-7883
Practice Address - Fax:775-826-4934
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV61781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice