Provider Demographics
NPI:1437384310
Name:DONALDSON, JEAN T (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:T
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 DONALDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551-4158
Mailing Address - Country:US
Mailing Address - Phone:931-243-3788
Mailing Address - Fax:931-243-3788
Practice Address - Street 1:107 DONALDSON AVENUE
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551
Practice Address - Country:US
Practice Address - Phone:931-243-3788
Practice Address - Fax:931-243-3788
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0050561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice