NPI | 1801234489 |
---|---|
Former Name | JANICA J GILLETTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00202704) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D-4494) |
Enumeration Date | 2013-06-05 |
Last Update Date | 2019-08-06 |