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Individual

STEVEN GILLEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
ROUTE 19, NORTHGATE PLAZA, WASHINGTON, PA 15301
(724) 223-0750
(724) 223-8761
Mailing address
926 GREAT POND DR, SUITE 2003, ALTAMONTE SPRINGS, FL 32714-7244
(407) 772-5124
(407) 788-3572

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS028891
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014570640004
PA
05
0014570640006
PA
05
0014570640008
PA
05
0014570640009
PA
05
0014570640010
PA
05
0014570640011
PA
05
0014570640014
PA
05
0014570640016
PA
05
0014570640017
PA
05
0014570640018
PA
05
0014570640019
PA
05
0014570640020
PA
05
0014570640021
PA
Enumeration date
04/05/2006
Last updated
07/09/2007
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