Provider Demographics
NPI:1316392012
Name:GEORGE E GILLIAN DDS
Entity type:Organization
Organization Name:GEORGE E GILLIAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-225-4470
Mailing Address - Street 1:9700 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2124
Mailing Address - Country:US
Mailing Address - Phone:501-225-4470
Mailing Address - Fax:501-225-4489
Practice Address - Street 1:9700 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2124
Practice Address - Country:US
Practice Address - Phone:501-225-4470
Practice Address - Fax:501-225-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-30
Last Update Date:2016-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR17391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty