Organization
PORTAGE FAMILY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLISON T CRUTCHFIELD DMD, MPH (MEMBER)
(269) 830-6609
Entity
Organization
Contact information
Practice address
1112 E CENTRE AVE, PORTAGE, MI 49002-5575
(269) 327-3005
Mailing address
1112 E CENTRE AVE, PORTAGE, MI 49002-5575
(269) 327-3005
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/05/2019
Last updated
11/20/2024
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