Organization
CENTRE DENTAL ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A. WILER D.D.S. (PRESIDENT)
(269) 323-3128
Entity
Organization
Contact information
Practice address
621 W CENTRE AVE, PORTAGE, MI 49024-5307
(269) 323-3128
(269) 323-2005
Mailing address
621 W CENTRE AVE, PORTAGE, MI 49024-5307
(269) 323-3128
(269) 323-2005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
09572
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619019700
DENTIST GENERAL PRACTICE
MI
Enumeration date
03/28/2007
Last updated
08/22/2020
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