Organization
PAUL A. GILLEY, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL A. GILLEY D.D.S. (OWNER/PRESIDENT)
(304) 425-2978
Entity
Organization
Contact information
Practice address
104 VINE ST, PRINCETON, WV 24740-3931
(304) 425-2978
(304) 487-2393
Mailing address
104 VINE ST, PRINCETON, WV 24740-3931
(304) 425-2978
(304) 487-2393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2854
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137530000
—
WV
Enumeration date
07/10/2006
Last updated
05/29/2013
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