Portage Pediatric Dentistry PLC
Portage Pediatric Dentistry PLC provides Pediatric Dentistry in Portage, Michigan. Licensed in Michigan. Registered with an NPI since 2015.
- Licensed in
- MI
- In the registry since
- 2015
- Specialties on file
- 2
Practice location Address checks out
6121 S Westnedge AvePortage, MI 49002-2882 Not confirmed with CMS for 10 years — call before visiting
Phone: (269) 323-8016
Fax: (269) 323-8524
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatric Dentistry (primary) | Taxonomy 1223P0221X · Licence 2901020339 (MI) |
|---|---|
| Pediatric Dentistry | Taxonomy 1223P0221X · Licence 2901009877 (MI) |
Record details
| NPI number | 1366817827 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jody Wrathall — Owner · (269) 323-8016 |
| Other names | Portage Pediatric Dentistry |
| NPI enumerated | December 9, 2015 |
| Last updated in NPPES | December 9, 2015 |
| Mailing address | 6121 S Westnedge Ave, Portage, MI 49002-2882 |
Other providers in Portage
-
Cbmi2 PLLC
3020 Old Centre Rd, Portage, MI 49024-4883 · (269) 323-8016
-
Chuandi Wang Pediatric Dentistry PC
5907 Oakland Dr, Portage, MI 49024-1120 · (269) 327-4459
-
Dr. John H Deppen, DDS
6121 S Westnedge Ave, Portage, MI 49002-2882 · (269) 323-8016
-
Jackie Hwang
3020 Old Centre Rd, Portage, MI 49024-4883 · (269) 323-8016