Provider Demographics
NPI:1730362492
Name:DAOUD, JOURAISH MOHAMMED (DMD)
Entity type:Individual
Prefix:DR
First Name:JOURAISH
Middle Name:MOHAMMED
Last Name:DAOUD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N M 52
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:49285-9766
Mailing Address - Country:US
Mailing Address - Phone:517-851-8902
Mailing Address - Fax:517-851-9241
Practice Address - Street 1:2600 N M 52
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MI
Practice Address - Zip Code:49285-9766
Practice Address - Country:US
Practice Address - Phone:517-851-8902
Practice Address - Fax:517-851-9241
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI18924122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist