Organization
DENTISTS OF BROADMOOR, LLP
Active
Other names
Dentists of Broadmoor
Organization subpart
No
Provider details
NPI number
Authorized official
JANICA J GILLETTE-BACKSTROM DDS (OWNER)
(719) 249-8775
Entity
Organization
Contact information
Practice address
160 EAST CHEYENNE ROAD, SUITE 120, COLORADO SPRINGS, CO 80906
(719) 249-8775
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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