| Periodontic Associates Of Port Huron | |
|
1175 Thomas Edison Dr Port Huron MI 48060-8500 | |
| (810) 987-1400 | |
| (810) 987-1349 |
| Full Name | Periodontic Associates Of Port Huron |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1175 Thomas Edison Dr, Port Huron, Michigan |
| Authorized Official Name and Position | Mark Koenen Setter (OWNER) |
| Authorized Official Contact | 8109871400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Periodontic Associates Of Port Huron 1175 Thomas Edison Dr Port Huron MI 48060-8500 Ph: (810) 987-1400 | Periodontic Associates Of Port Huron 1175 Thomas Edison Dr Port Huron MI 48060-8500 Ph: (810) 987-1400 |
| NPI Number | 1962783399 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 08/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962783399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | MS012152 (Michigan) | Primary |
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