Provider Demographics
NPI:1073525366
Name:MICHAEL J. PAQUETTE, D.D.S., INC.
Entity type:Organization
Organization Name:MICHAEL J. PAQUETTE, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-838-7561
Mailing Address - Street 1:381 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3251
Mailing Address - Country:US
Mailing Address - Phone:714-838-7561
Mailing Address - Fax:714-838-2873
Practice Address - Street 1:381 E 1ST ST
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3251
Practice Address - Country:US
Practice Address - Phone:714-838-7561
Practice Address - Fax:714-838-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty