Organization
JOHN C. GILMORE, JR., D.M.D., P.A.
Active
Other names
Gilmore Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CONNALLY GILMORE JR. D.M.D. (PRESIDENT, DENTIST)
(850) 476-4283
Entity
Organization
Contact information
Practice address
1759 CREIGHTON RD, PENSACOLA, FL 32504-7145
(850) 476-4283
(850) 476-9709
Mailing address
1759 CREIGHTON RD, PENSACOLA, FL 32504-7145
(850) 476-4283
(850) 476-9709
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
790060
UNITED CONCORDIA PROVIDER
—
Enumeration date
03/07/2007
Last updated
06/16/2008
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