# MIDWEST FAMILY DENTAL CARE PORTAGE PC

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

## Provider details

- **NPI number:** 1902782592
- **Authorized official:** PAIGE COCHRAN (BILLING MANAGER)
- **Authorized official phone:** (269) 355-6072

## Contact information

- **Practice address:** 706 W CENTRE AVE, PORTAGE, MI 49024-5310
- **Practice address phone:** (269) 323-1679
- **Mailing address:** 706 W CENTRE AVE, PORTAGE, MI 49024-5310

## Taxonomy

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

## Other

- **Enumeration date:** 08/12/2025
- **Last updated:** 08/12/2025