| Portage Family Dentistry Pllc | |
|
200 E Centre Ave Portage MI 49002-5505 | |
| (269) 327-3005 | |
| Not Available |
| Full Name | Portage Family Dentistry Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 200 E Centre Ave, Portage, Michigan |
| Authorized Official Name and Position | Allison T Crutchfield (MEMBER) |
| Authorized Official Contact | 4803355351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portage Family Dentistry Pllc 5260 Saddle Club Dr Kalamazoo MI 49009-9773 Ph: (480) 335-5351 | Portage Family Dentistry Pllc 200 E Centre Ave Portage MI 49002-5505 Ph: (269) 327-3005 |
| NPI Number | 1407493760 |
|---|---|
| Provider Enumeration Date | 12/05/2019 |
| Last Update Date | 12/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407493760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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