Tru Dental Michigan PC
Dentist, General Practice in Portland, MI. Organization (NPI-2).
NPI number1770164980
StatusActive
Last updated in NPPESApr 19, 2021
Details
- NPI
- 1770164980
- Entity type
- Organization (NPI-2)
- Legal business name
- Tru Dental Michigan PC
- Organization subpart
- Yes
- Enumeration date
- Apr 19, 2021
- Certification date
- Apr 19, 2021
- Last updated
- Apr 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Tru Family Dental - Portland (Doing Business As)
Practice location
155 Rowe AvePortland, MI 48875-1645
Phone 517-647-6205 · Fax 517-647-6205
Mailing address
155 Rowe AvePortland, MI 48875-1645
Phone 517-647-6205 · Fax 517-647-6205
Authorized official
Celia Hayes
Credentialing Coordinator
2175402100
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