Individual
KRYSTAL GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 E OHIO ST, CLINTON, MO 64735-2458
(660) 885-6933
Mailing address
1108 E OHIO ST, CLINTON, MO 64735-2458
(660) 885-6933
(660) 885-6935
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
08688
IA
1223G0001X
General Practice Dentistry
Primary
2008016892
MO
Other
Enumeration date
01/17/2010
Last updated
11/01/2023
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