Provider Demographics
NPI:1609079185
Name:DUGAN, COLLEEN PATRICIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:PATRICIA
Last Name:DUGAN
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:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-0907
Mailing Address - Country:US
Mailing Address - Phone:508-888-6926
Mailing Address - Fax:508-888-2728
Practice Address - Street 1:135 ROUTE 6A
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2060
Practice Address - Country:US
Practice Address - Phone:508-888-2728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice