Organization
GILLIS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL GILLIS (DDS)
(660) 995-6933
Entity
Organization
Contact information
Practice address
2000 N GAINES DR, CLINTON, MO 64735-1132
(660) 885-6933
(660) 885-6935
Mailing address
2000 N GAINES DR, CLINTON, MO 64735-1132
(660) 885-6933
(660) 885-6935
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2008016892
MO
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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