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General NPI Number Information
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NPI Number | 1154697209
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Entity Type | Organization
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Legal Business Name | DARRYL E. GILMORE, DDS, PC
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Dates
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Enumeration Date | 03/22/2012
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Last Update Date | 03/22/2012
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Provider Practice Location Address
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Address Line | 137 MERCHANTS ROW SUITE 121
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City | ARLINGTON
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State | TX
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Zip | 76018
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Country | US
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Telephone | 817-375-8899
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Fax | 817-375-9339
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Provider Business Mailing Address
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Address Line | 137 MERCHANTS ROW SUITE 121
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City | ARLINGTON
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State | TX
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Zip | 76018
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Country | US
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Telephone | 817-375-8899
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Fax | 817-375-9339
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Authorized Official
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Title or Position | OWNER
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Name | MR. DARRYL E GILMORE
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Credential | ORTHODONTICS
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Telephone | 817-375-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 24324
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License Number State | TX
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