MEDICARE: DR. DEBORIA FRANCES GILL D.D.S.

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	5426	OK

General Provider Information

NPI Number	:	1568467504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORIA FRANCES GILL D.D.S.

Provider Business Mailing Address
First Line	:	6141 E 91ST ST
Second Line	:	STE 204
City	:	TULSA
State	:	OK
Zip	:	74137-3104
Country	:	US
Telephone Number	:	918-747-4444
Fax Number	:	918-747-1140

Provider Business Practice Location Address
First Line	:	6141 E 91ST ST
Second Line	:	STE 204
City	:	TULSA
State	:	OK
Zip	:	74137-3104
Country	:	US
Telephone Number	:	918-747-4444
Fax Number	:	918-747-1140

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	01/25/2016

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