Organization · Type 2 NPI
Russell E. Gilliom, D.d.s., P.c.
Dental Clinic/Center · Churubusco, IN
NPI number
1902021827
Active
Practice location
230 E Whitley St
Churubusco, IN 46723-1506
Fax (260) 693-6422
Mailing address
PO Box 265
Churubusco, IN 46723-0265
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 54000935A (IN) |
Dental Clinic/Center: Definition to come...
4 other providers at this address
Other dental clinic/center providers in Churubusco
About NPI 1902021827
Russell E. Gilliom, D.d.s., P.c.'s National Provider Identifier is 1902021827, issued on Apr 16, 2007. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Churubusco, IN. The record was last updated on Aug 22, 2020.