Portage Northern Dental

NPI #1295486512 in Portage, Michigan

Provider Information

NPI Number
1295486512
Entity Type
Organization
Organization Name
Portage Northern Dental
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Jan 18, 2022
Last Updated
Jan 18, 2022

Practice Location

Address
1220 W MILHAM AVE
ZIP Code
49024-1206
Phone
(269) 382-5040

Authorized Official

Name
RENEE HEISE
Title
INSURANCE SPECIALIST
Phone
(231) 246-2204

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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