Provider Demographics
NPI:1043871015
Name:DUBUQUE, PAUL J (DMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:DUBUQUE
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 1:173 NH ROUTE 104 STE A
Mailing Address - Street 2:
Mailing Address - City:MEREDITH
Mailing Address - State:NH
Mailing Address - Zip Code:03253-5732
Mailing Address - Country:US
Mailing Address - Phone:603-515-4060
Mailing Address - Fax:603-782-0868
Practice Address - Street 1:173 NH ROUTE 104 STE A
Practice Address - Street 2:
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-5732
Practice Address - Country:US
Practice Address - Phone:603-515-4060
Practice Address - Fax:603-782-0868
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist