Gillis, John Malcolm
Gillis, John Malcolm is an individual health care provider with primary practice located at 1441 N 12Th St Fl 23 , Phoenix AZ 85006-2837. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gillis, John Malcolm can be contacted via phone (602) 521-5150.Contact Information
Primary practice address
1441 N 12Th St Fl 23
Phoenix AZ 85006-2837
Phone: (602) 521-5150
Fax: (602) 521-5151
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 6147 | Arizona |
Profile Details
| NPI number | 1083673610 |
|---|---|
| LBN Legal business name | Gillis, John Malcolm |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jan 17th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083673610 | NPPES |
| Arizona | MEDICAID | 931982 |
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