Individual
DR. DEANA LOUISE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1599 JONES ST, GRAND FORKS AFB, ND 58205
(701) 747-5601
Mailing address
1599 JONES ST, GRAND FORKS AFB, ND 58205
(701) 747-5601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R1361
TX
2083X0100X
Occupational Medicine Physician
Primary
R1361
TX
Other
Enumeration date
09/25/2006
Last updated
12/03/2025
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