Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2050 | AR |
NPI | 1003929084 |
---|---|
Provider Name | Robert Eugene Gilbert |
First Address | Paris, AR 72855-3717 |
Second Address | Paris, AR 72855-3717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/07/2007 |