Individual
STEPHEN T GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1600 N RIVERSIDE AVE, 1164, MEDFORD, OR 97501-4652
(541) 776-6996
(541) 776-0996
Mailing address
1600 N RIVERSIDE AVE, 1164, MEDFORD, OR 97501-4652
(541) 776-6996
(541) 776-0996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7356
OR
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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