Provider Demographics
NPI:1174846000
Name:DAL PONTE, JEAN DIANE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:DIANE
Last Name:DAL PONTE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10450 N LA CANADA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-7027
Mailing Address - Country:US
Mailing Address - Phone:520-877-9269
Mailing Address - Fax:520-531-8281
Practice Address - Street 1:10450 N LA CANADA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85737-7027
Practice Address - Country:US
Practice Address - Phone:520-877-9269
Practice Address - Fax:520-531-8281
Is Sole Proprietor?:No
Enumeration Date:2010-03-06
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist