General Dentistry Pc | |
1522 W Centre Avenue Portage MI 49024 | |
(269) 327-6765 | |
(269) 327-1138 |
Full Name | General Dentistry Pc |
---|---|
Speciality | Dentist |
Location | 1522 W Centre Avenue, Portage, Michigan |
Authorized Official Name and Position | Robert Leon Nicola (OWNER) |
Authorized Official Contact | 2693276765 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
General Dentistry Pc 1522 W Centre Avenue Portage MI 49024 Ph: (269) 327-6765 | General Dentistry Pc 1522 W Centre Avenue Portage MI 49024 Ph: (269) 327-6765 |
NPI Number | 1639204852 |
---|---|
Provider Enumeration Date | 02/21/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639204852 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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