Individual
DR. JONATHAN WADE GILLESBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
530 RIVERSIDE DRIVE, DOWAGIAC, MI 49047
(269) 782-5161
(269) 782-1126
Mailing address
530 RIVERSIDE DRIVE, DOWAGIAC, MI 49047
(269) 782-5161
(269) 782-1126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901017899
MI
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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