Individual
DR. GRANT BRANDON GILLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5069 UNIVERSITY PKWY, WINSTON SALEM, NC 27106-6083
(336) 714-5726
Mailing address
515 E GRANT RD, STE 114-354, TUCSON, AZ 85705-5797
(520) 209-1608
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10881
NC
122300000X
Dentist
D009476
AZ
1223G0001X
General Practice Dentistry
10881
NC
Other
Enumeration date
06/15/2016
Last updated
09/20/2021
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