Individual
TIMBERLY SUE DAOUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
302 S FRONT ST STE A, DOWAGIAC, MI 49047-1750
(269) 782-0064
Mailing address
4774 BAHAMA LN, PORTAGE, MI 49002-9045
(269) 271-2291
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902013577
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2902013577
DENTAL HYGIENE LICENSE
MI
Enumeration date
11/20/2019
Last updated
11/20/2019
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