Merit Dental Michigan PC

NPI #1952737538 in Portage, Michigan

Provider Information

NPI Number: 1952737538
Entity Type: Organization
Organization Name: Merit Dental Michigan PC
Primary Specialty: Dentist
Enumeration Date: Sep 16, 2013
Last Updated: Sep 16, 2013

Practice Location

Address: 3060 W CENTRE AVE OFC B
City: Portage
State: Michigan
ZIP Code: 49024-4825
Phone: (715) 926-5050

Authorized Official

Name: JEFFREY MOOS, DDS
Title: OWNER
Phone: (715) 926-5050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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