Provider Demographics
NPI:1962462853
Name:GILL, RICHARD F (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:GILL
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 1:14500 GATORLAND DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6915
Mailing Address - Country:US
Mailing Address - Phone:407-857-0800
Mailing Address - Fax:407-857-5847
Practice Address - Street 1:14500 GATORLAND DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6915
Practice Address - Country:US
Practice Address - Phone:407-857-0800
Practice Address - Fax:407-857-5847
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 100531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics