Provider Demographics
NPI:1740351303
Name:GILLESPIE, TERRI A (DDS)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:A
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116
Mailing Address - Country:US
Mailing Address - Phone:303-841-7045
Mailing Address - Fax:303-841-7829
Practice Address - Street 1:12539 N HIWAY 83
Practice Address - Street 2:SUITE B
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-841-7045
Practice Address - Fax:303-841-7829
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO65381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice