Provider Demographics
NPI:1528052230
Name:GASKILL, EFFIE N (DDS, PA)
Entity type:Individual
Prefix:MRS
First Name:EFFIE
Middle Name:N
Last Name:GASKILL
Suffix:
Gender:F
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W 6TH ST
Mailing Address - Street 2:P.O. BOX G
Mailing Address - City:HUGOTON
Mailing Address - State:KS
Mailing Address - Zip Code:67951-2206
Mailing Address - Country:US
Mailing Address - Phone:620-544-8800
Mailing Address - Fax:620-544-8801
Practice Address - Street 1:114 W 6TH ST
Practice Address - Street 2:
Practice Address - City:HUGOTON
Practice Address - State:KS
Practice Address - Zip Code:67951-2206
Practice Address - Country:US
Practice Address - Phone:620-544-8800
Practice Address - Fax:620-544-8801
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS600281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS102547OtherBLUE CROSS BLUE SHIELD