Individual
DR. ROBERT TURNER GILLAM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
508 E MAIN ST, SUITE 322, ELIZABETH CITY, NC 27909-4494
(252) 335-4545
(252) 335-4842
Mailing address
508 E MAIN ST, SUITE 322, ELIZABETH CITY, NC 27909-4494
(252) 335-4545
(252) 335-4842
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7886
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871094
UNITED CONCORDIA ID#
NC
05
—
89902X2
—
NC
01
—
902X2
BLUE CROSS NC ID#
NC
Enumeration date
12/27/2006
Last updated
07/09/2007
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