Organization
WEST MILHAM DENTAL PROF PC
Active
Other names
Mary Ann Bukowski DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ANN BUKOWSKI DDS (OWNER DENTIST)
(269) 381-0564
Entity
Organization
Contact information
Practice address
1416 W MILHAM, PORTAGE, MI 49024-2245
(269) 381-0564
(269) 381-4965
Mailing address
1416 W MILHAM, PORTAGE, MI 49024-2245
(269) 381-0564
(269) 381-4965
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901011980
MI
Other
Enumeration date
09/29/2006
Last updated
08/22/2020
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