Organization
RICHARD WAYNE GILREATH,DDS,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD WAYNE GILREATH DDS (PRESIDENT)
(336) 786-8334
Entity
Organization
Contact information
Practice address
1142 S SOUTH ST, MOUNT AIRY, NC 27030-5332
(336) 786-8334
(336) 786-8250
Mailing address
1142 S SOUTH ST, MOUNT AIRY, NC 27030-5332
(336) 786-8334
(336) 786-8250
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6035
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
281
TRIGON
NC
01
—
281989
ANTHEM
NC
01
—
764612
UNITED CONCORDIA
NC
05
—
8993193
—
NC
01
—
93193
BLUE CROSSBLUE SHIELD
NC
Enumeration date
01/22/2007
Last updated
08/22/2020
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