Russell E. Gilliom, D.d.s., P.c.
NPI #1902021827 in Churubusco, Indiana
Provider Information
- NPI Number
- 1902021827
- Entity Type
- Organization
- Organization Name
- Russell E. Gilliom, D.d.s., P.c.
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Apr 16, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 230 E WHITLEY ST
- City
- Churubusco
- State
- Indiana
- ZIP Code
- 46723-1506
- Phone
- (260) 693-2177
Authorized Official
- Name
- DR. RUSSELL E. GILLIOM, D.D.S.
- Title
- PRESIDENT
- Phone
- (260) 693-2177
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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