Organization
STEPHEN B GILLESPIE DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN GILLESPIE (SOLE MEMBER)
(360) 892-6132
Entity
Organization
Contact information
Practice address
13200 SE MCGILLIVRAY BLVD, VANCOUVER, WA 98683-7040
(360) 892-6132
Mailing address
PO BOX 25528, TEMPE, AZ 85285-5528
(480) 444-0607
(480) 777-1345
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE 00005353
WA
Other
Enumeration date
05/11/2010
Last updated
02/13/2015
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