Healthcare Provider Details

I. General information

NPI: 1235153941
Provider Name (Legal Business Name): RICHARD S GILMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MCGEE DR STE 121
NORMAN OK
73072-6705
US

IV. Provider business mailing address

2500 MCGEE DR STE 121
NORMAN OK
73072-6705
US

V. Phone/Fax

Practice location:
  • Phone: 405-364-4608
  • Fax: 405-364-3805
Mailing address:
  • Phone: 405-364-4608
  • Fax: 405-364-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3808
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: