Provider Demographics
NPI:1841407954
Name:MCDONALD, JANET JILL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:JILL
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 FAIRGROUNDS RD # A
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5648
Mailing Address - Country:US
Mailing Address - Phone:731-642-2314
Mailing Address - Fax:731-642-2317
Practice Address - Street 1:60 FAIRGROUNDS RD # A
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5648
Practice Address - Country:US
Practice Address - Phone:731-642-2314
Practice Address - Fax:731-642-2317
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN70511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice