Provider Demographics
NPI:1326380353
Name:DEPTO, JILL (DVM)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DEPTO
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STRATHMORE RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-2418
Mailing Address - Country:US
Mailing Address - Phone:508-319-2117
Mailing Address - Fax:
Practice Address - Street 1:5 STRATHMORE RD
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-2418
Practice Address - Country:US
Practice Address - Phone:508-319-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-16
Last Update Date:2013-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6466174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian