Individual
DR. JERE SCOTT GILLAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
800 E MERRITT CSWY, MERRITT ISLAND, FL 32952-3514
(321) 453-8882
Mailing address
9388 RAVENS WILLOW DR, ORLANDO, FL 32827-7080
(407) 929-0511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19418
FL
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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