Individual
CARLEE GILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8691 LINE AVE, SHREVEPORT, LA 71106-6148
(328) 701-8885
Mailing address
627 SILKWOOD DR, BENTON, LA 71006-5000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7004
LA
Other
Enumeration date
06/20/2019
Last updated
06/20/2019
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