Gilliam & Gilliam PLLC
Dentist, Pediatric Dentistry in Jacksonville, NC. Organization (NPI-2).
NPI number1174635882
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1174635882
- Entity type
- Organization (NPI-2)
- Legal business name
- Gilliam & Gilliam PLLC
- Organization subpart
- No
- Enumeration date
- Aug 31, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | 6034 | NC | Yes |
| 1223G0001X | Dentist, General Practice | 5688 | NC |
Other names
- Gilliam Dentistry (Former Legal Business Name)
Practice location
2 Office Park DrJacksonville, NC 28546
Phone 910-577-5077 · Fax 910-577-1907
Mailing address
2 Office Park DrJacksonville, NC 28546
Phone 910-577-5077 · Fax 910-577-1907
Authorized official
Anna Maria Johnson
Office Manager
9105775077
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