Provider Demographics
NPI:1609024777
Name:DUQUETTE, DOUGLAS W (DDS)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:W
Last Name:DUQUETTE
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 1:7515 W YALE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3423
Mailing Address - Country:US
Mailing Address - Phone:303-988-3319
Mailing Address - Fax:303-998-3492
Practice Address - Street 1:7515 W YALE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-3423
Practice Address - Country:US
Practice Address - Phone:303-988-3319
Practice Address - Fax:303-998-3492
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO88831223G0001X
MI124791223G0001X
IL175791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice