Portable Dental Services
NPI #1437483484 in Shelby Twp, Michigan
Provider Information
- NPI Number
- 1437483484
- Entity Type
- Organization
- Organization Name
- Portable Dental Services
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 23, 2009
- Last Updated
- Sep 23, 2009
Practice Location
- Address
- 15055 22 MILE RD # 2
- City
- Shelby Twp
- State
- Michigan
- ZIP Code
- 48315-4401
- Phone
- (586) 873-5567
Authorized Official
- Name
- ROBERT VANCE ANTOLAK
- Title
- PRESIDENT
- Phone
- (586) 873-5567
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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