Individual
DR. SUZANNE K PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS MS
Contact information
Practice address
291 W LAKEWOOD BLVD, HOLLAND, MI 49424
(616) 392-1100
(616) 396-1117
Mailing address
291 W LAKEWOOD BLVD, HOLLAND, MI 49424
(616) 392-1100
(616) 396-1117
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2901018529
MI
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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