Dr. Charles Michael Gilliam, DDS
Dentist in Pompano Beach, FL. Individual provider (NPI-1).
NPI number1679780902
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1679780902
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles Michael Gilliam
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 17, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 10912 | FL | Yes |
Practice location
2700 Ne 14th Street CswySuite #105
Pompano Beach, FL 33062-3561
Phone 954-941-2412 · Fax 954-784-7984
Mailing address
2700 Ne 14th Street CswySuite #105
Pompano Beach, FL 33062-3561
Phone 954-941-2412 · Fax 954-784-7984
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