Individual
GEORGE GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
161 MADISON AVENUE, SUITE 7NW, NEW YORK, NY 10016-5449
(212) 481-3636
(212) 481-7878
Mailing address
161 MADISON AVENUE, SUITE 7NW, NEW YORK, NY 10016-5449
(212) 481-3636
(212) 481-7878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
031908
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00347360
—
NY
Enumeration date
07/18/2007
Last updated
07/18/2007
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