Provider Demographics
NPI:1619178886
Name:PAQUETTE, CYNTHIA E (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:E
Last Name:PAQUETTE
Suffix:
Gender:F
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20609 E 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1401
Mailing Address - Country:US
Mailing Address - Phone:586-774-8090
Mailing Address - Fax:586-447-8900
Practice Address - Street 1:20609 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1401
Practice Address - Country:US
Practice Address - Phone:586-774-8090
Practice Address - Fax:586-447-8900
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI 15801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist