| 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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