Provider Demographics
NPI:1861586703
Name:GILL, SEAN ANDREW (DMD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:ANDREW
Last Name:GILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 TOWER WAY STE 2030
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5786
Mailing Address - Country:US
Mailing Address - Phone:724-853-1600
Mailing Address - Fax:724-853-4012
Practice Address - Street 1:2000 TOWER WAY STE 2030
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5786
Practice Address - Country:US
Practice Address - Phone:724-853-1600
Practice Address - Fax:724-853-4012
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0350741223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry