Katelyn M Nieten DDS Plc
Clinic/Center, Dental in Mount Pleasant, MI. Organization (NPI-2).
NPI number1295464451
StatusActive
Last updated in NPPESSep 13, 2022
Details
- NPI
- 1295464451
- Entity type
- Organization (NPI-2)
- Legal business name
- Katelyn M Nieten DDS Plc
- Organization subpart
- No
- Enumeration date
- Jun 5, 2022
- Certification date
- Sep 13, 2022
- Last updated
- Sep 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Broadway Family Dentistry (Doing Business As)
Practice location
611 E Broadway StMount Pleasant, MI 48858-2793
Phone 989-773-5299
Mailing address
611 E Broadway StMount Pleasant, MI 48858-2793
Authorized official
Katelyn Nieten
Owner
9897636094
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All 6 Dental Clinic/Center providers in Mount Pleasant · All 748 providers in Mount Pleasant
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