Individual
DREW GILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
375 E LAGOON ST,, ROOSEVELT, UT 84066, ROOSEVELT, UT 84066
(435) 722-9995
Mailing address
483 N 190 E, ROOSEVELT, UT 84066-2573
(801) 707-7825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9816603-9922
UT
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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