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Organization
PERIODONTIC ASSOCIATES OF PORT HURON
Active
Organization
PERIODONTIC ASSOCIATES OF PORT HURON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK KOENEN SETTER D.D.S., M.S. (OWNER)
(810) 987-1400
Entity
Organization
Contact information
Practice address
1175 THOMAS EDISON DR, PORT HURON, MI 48060-8500
(810) 987-1400
(810) 987-1349
Mailing address
1175 THOMAS EDISON DR, PORT HURON, MI 48060-8500
(810) 987-1400
(810) 987-1349
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
MS012152
MI
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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