Individual
DR. BRENT LESLIE GILLILAND
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
12TH AEROMEDICAL-DENTAL SQUADRON, 221 3RD STREET WEST, RANDOLPH AFB, TX 78150-4801
(210) 652-1846
(210) 652-1368
Mailing address
540 THOREAU TRL, SCHERTZ, TX 78154-1158
(210) 845-1387
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13335
TX
Other
Enumeration date
09/08/2005
Last updated
07/08/2007
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