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General NPI Number Information
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NPI Number | 1023242500
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Entity Type | Organization
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Legal Business Name | ESTATE OF DONALD J. TOUSIGNANT
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 1100 MICHIGAN AVE
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City | MARYSVILLE
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State | MI
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Zip | 48040-2112
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Country | US
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Telephone | 810-364-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 MICHIGAN AVE
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City | MARYSVILLE
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State | MI
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Zip | 48040-2112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PERSONAL REPRESENTATIVE
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Name | MS. KIMBERLY JANINE TOUSIGNANT
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Credential |
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Telephone | 810-364-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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