Individual
CYNTHIA NICOLE CHENNAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
669 AGENCY MAIN STREET, HARLEM, MT 59526
(406) 353-3168
(406) 353-3227
Mailing address
669 AGENCY MAIN STREET, HARLEM, MT 59526
(406) 353-3168
(406) 353-3227
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
15149
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15149
LICENSE
TX
Enumeration date
06/15/2010
Last updated
06/15/2010
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