Individual
JEANNINE DONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 POST RD, FAIRFIELD, CT 06824-6220
(203) 254-3780
Mailing address
320 POST RD, FAIRFIELD, CT 06824-6220
(516) 459-0325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011366
CT
1223G0001X
General Practice Dentistry
057814
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/21/2014
Last updated
07/21/2023
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