Provider Demographics
NPI:1902044720
Name:ROSS, GILBERT J (DDS)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:J
Last Name:ROSS
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:PO BOX 7134
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-7134
Mailing Address - Country:US
Mailing Address - Phone:340-778-5151
Mailing Address - Fax:340-778-5151
Practice Address - Street 1:ISLAND MEDICAL CENTER
Practice Address - Street 2:SUITE 18
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-778-5151
Practice Address - Fax:340-778-5151
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI5561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI556OtherSTATE LICENSE