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Organization

GREAT LAKES ENDODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT YEUNG DDS, MS (OWNER)
(269) 349-2189
Entity
Organization

Contact information

Practice address
950 TRADE CENTRE WAY, STE 225, PORTAGE, MI 49002-0487
(269) 349-2189
Mailing address
950 TRADE CENTRE WAY, STE 225, PORTAGE, MI 49002-0487
(269) 349-2189

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2901019963
MI

Other

Enumeration date
03/24/2017
Last updated
03/24/2017
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