Individual
LARRY HEATH GILLENWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1335 E CENTER ST, KINGSPORT, TN 37664-2489
(423) 247-5125
(423) 246-2564
Mailing address
1335 E CENTER ST, KINGSPORT, TN 37664-2489
(423) 247-5125
(423) 246-2564
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS0000002549
TN
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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