Provider Demographics
NPI:1457577082
Name:DROUIN, DONALD R (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:DROUIN
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 1:26 SHUNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-2442
Mailing Address - Country:US
Mailing Address - Phone:860-635-2344
Mailing Address - Fax:860-632-2097
Practice Address - Street 1:26 SHUNPIKE RD
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-2442
Practice Address - Country:US
Practice Address - Phone:860-635-2344
Practice Address - Fax:860-632-2097
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT49791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4979OtherDENTAL LICENSE NUMBER