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General NPI Number Information
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NPI Number | 1538567896
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Entity Type | Individual
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Provider Name | MS. DANA MARIE GILLETTE
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Gender | Female
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Dates
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Enumeration Date | 12/18/2014
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 5245 CENTENNIAL BLVD STE 207
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-4405
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Country | US
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Telephone | 719-402-3232
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Fax | 719-402-3232
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Provider Business Mailing Address
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Address Line | 5245 CENTENNIAL BLVD STE 207
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-4405
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Country | US
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Telephone | 719-402-3232
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Fax | 719-402-3232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH070090
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 024528
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH.002023537
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License Number State | CO
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