Port Pediatric Dentistry PC
Dentist, Pediatric Dentistry in Holland, MI. Organization (NPI-2).
NPI number1669080651
StatusActive
Last updated in NPPESJul 16, 2020
Details
- NPI
- 1669080651
- Entity type
- Organization (NPI-2)
- Legal business name
- Port Pediatric Dentistry PC
- Organization subpart
- No
- Enumeration date
- Jul 16, 2020
- Certification date
- Jul 16, 2020
- Last updated
- Jul 16, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
Practice location
291 W Lakewood BlvdHolland, MI 49424-1969
Phone 616-392-1100 · Fax 616-396-1117
Mailing address
291 W Lakewood BlvdHolland, MI 49424-1969
Phone 616-392-1100 · Fax 616-396-1117
Authorized official
Suzanne Kristen Port
Dentist/Owner
6163921100
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Other Pediatric Dentistry providers in Holland, MI
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- Harold Lincoln Robinson, DMDNPI 1477093425
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All 10 Pediatric Dentistry providers in Holland · All 2,693 providers in Holland
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