Individual
MARK LYNN GILMORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4655 STATE AVE, KANSAS CITY, KS 66102-3603
(913) 278-7977
(913) 278-5022
Mailing address
415 N GRAND AVE, PUEBLO, CO 81003-3111
(719) 546-3333
(719) 546-3334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2004014920
MO
1223G0001X
General Practice Dentistry
Primary
60274
KS
Other
Enumeration date
12/27/2005
Last updated
07/08/2007
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