General Dentistry PC

NPI #1639204852 in Portage, Michigan

Provider Information

NPI Number: 1639204852
Entity Type: Organization
Organization Name: General Dentistry PC
Primary Specialty: Dentist
Enumeration Date: Feb 21, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1522 W CENTRE AVENUE
City: Portage
State: Michigan
ZIP Code: 49024
Phone: (269) 327-6765

Authorized Official

Name: DR. ROBERT LEON NICOLA, DDS
Title: OWNER
Phone: (269) 327-6765

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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