Tru Dental Michigan PC

NPI #1770164980 in Portland, Michigan

Provider Information

NPI Number: 1770164980
Entity Type: Organization
Organization Name: Tru Dental Michigan PC
Subpart: Yes (part of a larger organization)
Parent Organization: TRU DENTAL MICHIGAN PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 19, 2021
Last Updated: Apr 19, 2021

Practice Location

Address: 155 ROWE AVE
City: Portland
State: Michigan
ZIP Code: 48875-1645
Phone: (517) 647-6205

Authorized Official

Name: CELIA HAYES
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-2100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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