Individual
MARK GILSTRAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
404 S ELM ST STE 108, JENKS, OK 74037-3714
(918) 417-2417
Mailing address
8223 S QUEBEC ST STE O, CENTENNIAL, CO 80112-3173
(720) 277-5930
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
119
OK
1223P0221X
Pediatric Dentistry
2020006360
MO
1223P0221X
Pediatric Dentistry
DEN.00203438
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2017
Last updated
03/29/2021
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