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Dr. Connie Bruce Gilliam, DDS
Pediatric Dentist in Jacksonville, North Carolina
NPI 1548460298

Connie Bruce Gilliam is a Pediatric Dentist based in Jacksonville, NC and is specialized in Pediatric Dentistry. Connie Bruce Gilliam practices in Jacksonville, NC and has the professional credentials of DDS. The NPI Number for Connie Bruce Gilliam is 1548460298 and holds a License No. 6034 (North Carolina).

The current practice location address for Connie Bruce Gilliam is 2 Office Park Dr, Jacksonville, NC and can be reached out via phone at 910-577-5077 and via fax at 910-577-1907.

Location: 2 Office Park Dr, Jacksonville, NC, 28546-7325
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548460298
Provider Name
Connie Bruce Gilliam
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
2 Office Park Dr, Jacksonville, NC, 28546-7325
Phone Number
910-577-5077
Fax Number
910-577-1907
Provider Enumeration Date
07/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
060913 01 NC UNITED CONCORDIA
8993221 05 NC
014CY 01 NC BCBS
institution
Provider Business Practice Location Address Details
Address
2 Office Park Dr
City
Jacksonville
State
North Carolina
Zip
28546-7325
Phone Number
910-577-5077
Fax Number
910-577-1907
person
Provider Business Mailing Address Details
Address
2 Office Park Dr
City
Jacksonville
State
North Carolina
Zip
28546-7325
Phone Number
910-577-5077
Fax Number
910-577-1907
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
6034 (North Carolina)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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