Organization
KATELYN M NIETEN DDS PLC
Active
Other names
Broadway Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATELYN NIETEN DDS (OWNER)
(989) 763-6094
Entity
Organization
Contact information
Practice address
611 E BROADWAY ST, MOUNT PLEASANT, MI 48858-2793
(989) 773-5299
Mailing address
611 E BROADWAY ST, MOUNT PLEASANT, MI 48858-2793
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2022
Last updated
09/13/2022
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