Organization
BLUE WATER DENTAL GROUP PORT HURON P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUANN THOMPSON (OFFICE MANAGER)
(810) 987-7224
Entity
Organization
Contact information
Practice address
803 SUPERIOR ST, PORT HURON, MI 48060-3764
(810) 987-7224
(810) 987-8585
Mailing address
803 SUPERIOR ST, PORT HURON, MI 48060-3764
(810) 987-7224
(810) 987-8585
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10502
MI
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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