Provider Demographics
NPI:1437726320
Name:DONAHUE, ASHLI NOELLE (DMD)
Entity Type:Individual
Prefix:
First Name:ASHLI
Middle Name:NOELLE
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5240 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:AU GRES
Mailing Address - State:MI
Mailing Address - Zip Code:48703-9592
Mailing Address - Country:US
Mailing Address - Phone:989-305-0356
Mailing Address - Fax:
Practice Address - Street 1:206 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:MI
Practice Address - Zip Code:48658-2539
Practice Address - Country:US
Practice Address - Phone:989-846-4090
Practice Address - Fax:989-846-4160
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600906122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist