Great Lakes Endodontics | |
950 Trade Centre Way Ste 225 Portage MI 49002-0487 | |
(269) 349-2189 | |
Not Available |
Full Name | Great Lakes Endodontics |
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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 |
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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 |
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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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