Individual
CATHLEEN CONSTANCE BOURQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
427 12TH ST, PLUMMER, ID 83851-4000
(208) 686-1931
Mailing address
6995 N CORNWALL ST, COEUR D ALENE, ID 83815-7101
(208) 699-2841
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH-1462
ID
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
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