MEDICARE: DR. PAUL DONOVAN GILBERT DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1884	SC

General Provider Information

NPI Number	:	1437151768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL DONOVAN GILBERT DMD

Provider Business Mailing Address
First Line	:	870 CLEVELAND ST
Second Line	:	STE 1C
City	:	GREENVILLE
State	:	SC
Zip	:	29601-4428
Country	:	US
Telephone Number	:	864-235-3438
Fax Number	:

Provider Business Practice Location Address
First Line	:	870 CLEVELAND ST
Second Line	:	STE 1C
City	:	GREENVILLE
State	:	SC
Zip	:	29601-4428
Country	:	US
Telephone Number	:	864-235-3438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/08/2007

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