# CAROLAN FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164778346
- **Authorized official:** KEVIN B CAROLAN D.D.S. (CEO)
- **Authorized official phone:** (810) 982-7682

## Contact information

- **Practice address:** 901 SUPERIOR ST, PORT HURON, MI 48060-3746
- **Practice address phone:** (810) 982-7682
- **Practice address fax:** (810) 984-2653
- **Mailing address:** 901 SUPERIOR ST, PORT HURON, MI 48060-3746
- **Mailing address phone:** (810) 982-7682
- **Mailing address fax:** (810) 984-2653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2012
- **Last updated:** 07/25/2012