Provider Demographics
NPI:1063501955
Name:METIVIER, DONALD JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JAMES
Last Name:METIVIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-0000
Mailing Address - Country:US
Mailing Address - Phone:603-352-0006
Mailing Address - Fax:
Practice Address - Street 1:650 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1799
Practice Address - Country:US
Practice Address - Phone:603-352-0006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH11891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice