Provider Demographics
NPI:1043427024
Name:PAQUETTE, ROGER R (DMD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:R
Last Name:PAQUETTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 OLD BOLTON RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-1243
Mailing Address - Country:US
Mailing Address - Phone:978-568-8672
Mailing Address - Fax:978-568-0553
Practice Address - Street 1:64 COX ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-1441
Practice Address - Country:US
Practice Address - Phone:978-562-6926
Practice Address - Fax:978-568-0553
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice