Organization
DRS MICHAEL J GAMBILL & COREY J CLOUD LLC
Active
Other names
Gleam Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTAL GOOD (OFFICE MANAGER)
(318) 742-9333
Entity
Organization
Contact information
Practice address
230 CARROLL ST, SHREVEPORT, LA 71105-4248
(318) 742-9333
Mailing address
2285 BENTON RD STE A100, BOSSIER CITY, LA 71111-3465
(318) 742-9333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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