Provider Demographics
NPI:1619944402
Name:OUELLETTE, DAVE LLOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVE
Middle Name:LLOYD
Last Name:OUELLETTE
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 1:3401 SPRINGHILL DR
Mailing Address - Street 2:SUITE 285
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2924
Mailing Address - Country:US
Mailing Address - Phone:501-955-0155
Mailing Address - Fax:501-955-0159
Practice Address - Street 1:3401 SPRINGHILL DR
Practice Address - Street 2:SUITE 285
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2924
Practice Address - Country:US
Practice Address - Phone:501-955-0155
Practice Address - Fax:501-955-0159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR20231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice