Individual
DR. JASON R GILLESPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S., D.D.S., M.S.
Contact information
Practice address
4118 MCCULLOUGH AVE STE 11, SAN ANTONIO, TX 78212-1905
(210) 828-1682
(210) 828-1683
Mailing address
4118 MCCULLOUGH AVE STE 11, SAN ANTONIO, TX 78212-1905
(210) 828-1682
(210) 828-1683
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
19001
TX
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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