Provider Demographics
NPI:1548232499
Name:DESCHENE, JAMES F (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:DESCHENE
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:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-0043
Mailing Address - Country:US
Mailing Address - Phone:970-532-4209
Mailing Address - Fax:970-532-4175
Practice Address - Street 1:430 BIMSON AVE
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-1395
Practice Address - Country:US
Practice Address - Phone:970-532-4209
Practice Address - Fax:970-532-4175
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1055731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice