Provider Demographics
NPI:1235363870
Name:DOUILLETTE, JEAN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:A
Last Name:DOUILLETTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:A
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:16 BARROWS ST.
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760
Mailing Address - Country:US
Mailing Address - Phone:508-695-3719
Mailing Address - Fax:508-695-0237
Practice Address - Street 1:16 BARROWS ST.
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760
Practice Address - Country:US
Practice Address - Phone:508-695-3719
Practice Address - Fax:508-695-0237
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA170981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice