Provider Demographics
NPI:1487677688
Name:DUFOUR, ANNETTE E (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:E
Last Name:DUFOUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 1ST AVE N.
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829
Mailing Address - Country:US
Mailing Address - Phone:906-786-3814
Mailing Address - Fax:906-786-3881
Practice Address - Street 1:1100 1ST AVE N.
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829
Practice Address - Country:US
Practice Address - Phone:906-786-3814
Practice Address - Fax:906-786-3881
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010160681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice