Organization
CBMI2 PLLC
Active
Other names
Portage Pediatric Dentistry PLC
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL GUEVARA (INSURANCE COORDINATOR)
(616) 264-4709
Entity
Organization
Contact information
Practice address
3020 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 323-8016
Mailing address
3020 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 323-8016
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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