Fontenette, Dominique Camille

Fontenette, Dominique Camille is an individual health care provider with primary practice located at 351 Sw 9Th St , Ontario OR 97914-2639. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is her primary health care specialty. Fontenette, Dominique Camille can be contacted via phone (541) 881-7000.

Contact Information

Primary practice address
351 Sw 9Th St Ontario OR 97914-2639
Phone: (541) 881-7000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 243657 Massachusetts

Profile Details

NPI number 1356549992
LBN Legal business name Fontenette, Dominique Camille
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2007
Last updated Dec 10th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356549992 NPPES
Massachusetts MEDICAID 110086500A
Massachusetts Other AA186492

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