Provider Demographics
NPI:1538379375
Name:GILL, GURIQBAL SINGH (DMD)
Entity type:Individual
Prefix:DR
First Name:GURIQBAL
Middle Name:SINGH
Last Name:GILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:GARRY
Other - Middle Name:
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:11234 ANDERSON ST
Mailing Address - Street 2:LLUMC, HOUSE STAFF OFFICE
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-514-0966
Mailing Address - Fax:
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:LLUMC, HOUSE STAFF OFFICE
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-514-0966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program