| Gilberto and Hillis Dentistry | |
|
2990 Raider Way Poplar Bluff MO 63901-5372 | |
| (573) 785-6699 | |
| (573) 785-3424 |
| Full Name | Gilberto and Hillis Dentistry |
|---|---|
| Speciality | Clinic/Center |
| Location | 2990 Raider Way, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Anderson Mark Gilberto (OWNER) |
| Authorized Official Contact | 5737856699 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilberto and Hillis Dentistry 2990 Raider Way Poplar Bluff MO 63901-5372 Ph: (573) 785-6699 | Gilberto and Hillis Dentistry 2990 Raider Way Poplar Bluff MO 63901-5372 Ph: (573) 785-6699 |
| NPI Number | 1780426445 |
|---|---|
| Provider Enumeration Date | 06/12/2024 |
| Last Update Date | 06/12/2024 |
| Certification Date | 06/12/2024 |
| Medicare PECOS PAC ID | 2567988827 |
|---|---|
| Medicare Enrollment ID | O20250711001733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780426445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
| Provider Name | Anderson M Gilberto |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1790270494 PECOS PAC ID: 5496080095 Enrollment ID: I20250711001834 |
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