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Russell E. Gilliom, D.d.s., P.c.
Dental Clinic/Center in Churubusco, Indiana
NPI 1902021827

Russell E. Gilliom, D.d.s., P.c. is a Dental Clinic/Center based in Churubusco, IN and is specialized in Dental. Russell E. Gilliom, D.d.s., P.c. practices in Churubusco, IN. The NPI Number for Russell E. Gilliom, D.d.s., P.c. is 1902021827 and holds a License No. 54000935A (Indiana).

The current practice location address for Russell E. Gilliom, D.d.s., P.c. is 230 E Whitley St, Churubusco, IN and can be reached out via phone at 260-693-2177 and via fax at 260-693-6422.

Location: 230 E Whitley St, Churubusco, IN, 46723-0265
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1902021827
Provider Name
Russell E. Gilliom, D.d.s., P.c.
Credential
Provider Entity Type
Organization
Address
230 E Whitley St, Churubusco, IN, 46723-0265
Phone Number
260-693-2177
Fax Number
260-693-6422
Provider Enumeration Date
04/16/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
230 E Whitley St
City
Churubusco
State
Indiana
Zip
46723-1506
Phone Number
260-693-2177
Fax Number
260-693-6422
person
Provider Business Mailing Address Details
Address
230 E Whitley St
City
Churubusco
State
Indiana
Zip
46723-1506
Phone Number
260-693-2177
Fax Number
260-693-6422
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
54000935A (Indiana)
Definition
Definition to come...
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