Provider Demographics
NPI:1679540447
Name:VELDE, JEANNE
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:
Last Name:VELDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:209 SUMMER ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6313
Practice Address - Country:US
Practice Address - Phone:978-373-1231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice