| Cotter & Easton General Dentistry, Pllc | |
|
1125 Thomas Edison Dr Port Huron MI 48060-8500 | |
| (810) 982-9821 | |
| (810) 982-9645 |
| Full Name | Cotter & Easton General Dentistry, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1125 Thomas Edison Dr, Port Huron, Michigan |
| Authorized Official Name and Position | Jeffrey Waldemar Easton Ii (PARTNER DENTIST) |
| Authorized Official Contact | 8103575683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cotter & Easton General Dentistry, Pllc 1125 Thomas Edison Dr Port Huron MI 48060-8500 Ph: (810) 982-9821 | Cotter & Easton General Dentistry, Pllc 1125 Thomas Edison Dr Port Huron MI 48060-8500 Ph: (810) 982-9821 |
| NPI Number | 1538724828 |
|---|---|
| Provider Enumeration Date | 05/02/2019 |
| Last Update Date | 05/02/2019 |
| Medicare PECOS PAC ID | 1153664511 |
|---|---|
| Medicare Enrollment ID | O20190528002527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538724828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Jeffrey W Easton |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1689122061 PECOS PAC ID: 1658658158 Enrollment ID: I20170511000268 |
| Provider Name | James P Cotter |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1528274339 PECOS PAC ID: 3971823550 Enrollment ID: I20170511001784 |
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