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General NPI Number Information
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NPI Number | 1942429147
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Entity Type | Organization
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Legal Business Name | THOMAS E OUELLETTE DDS PC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 1391 SPEER BLVD STE 540
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City | DENVER
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State | CO
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Zip | 80204-2571
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Country | US
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Telephone | 303-296-1402
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Fax | 303-293-8729
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Provider Business Mailing Address
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Address Line | 1391 SPEER BLVD STE 540
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City | DENVER
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State | CO
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Zip | 80204-2571
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Country | US
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Telephone | 303-296-1402
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Fax | 303-293-8729
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Authorized Official
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Title or Position | DENTIST
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Name | DR. THOMAS ERIC OUELLETTE
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Credential | DDS
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Telephone | 303-296-1402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 006952
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License Number State | CO
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