Individual
DR. JANICA JOLI GILLETTE-BACKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H., D.D.S
Contact information
Practice address
6940 MESA RIDGE PARKWAY, FOUNTAIN, CO 80817
(719) 382-4936
(719) 382-4938
Mailing address
4680 STONE MANOR HTS, COLORADO SPRINGS, CO 80906-8605
(208) 251-9803
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D-4494
ID
1223G0001X
General Practice Dentistry
Primary
DEN.00202704
CO
Other
Enumeration date
06/05/2013
Last updated
08/06/2019
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