Individual
MRS. AMANDA ELIZABETH COATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10111 E ATHERTON RD, DAVISON, MI 48423-8704
(810) 836-3720
Mailing address
10111 E ATHERTON RD, DAVISON, MI 48423-8704
(810) 836-3720
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902017919
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124Q00000X
—
MI
Enumeration date
09/12/2016
Last updated
09/12/2016
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