| Great Lakes Endodontics | |
|
950 Trade Centre Way Ste 225 Portage MI 49002-0487 | |
| (269) 349-2189 | |
| Not Available |
| Full Name | Great Lakes Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 950 Trade Centre Way, Portage, Michigan |
| Authorized Official Name and Position | Robert Yeung (OWNER) |
| Authorized Official Contact | 2693492189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Endodontics 950 Trade Centre Way Ste 225 Portage MI 49002-0487 Ph: (269) 349-2189 | Great Lakes Endodontics 950 Trade Centre Way Ste 225 Portage MI 49002-0487 Ph: (269) 349-2189 |
| NPI Number | 1659802395 |
|---|---|
| Provider Enumeration Date | 03/24/2017 |
| Last Update Date | 03/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659802395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 2901019963 (Michigan) | Primary |
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