Organization
PERIDONTIC ASSOCIATES OF PORT HURON PLLC
Active
Other names
Periodontic Associates of Port Huron
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON GEORGE SOUYIAS D.D.S (PARTNER)
(810) 987-1400
Entity
Organization
Contact information
Practice address
1175 THOMAS EDISON DR, PORT HURON, MI 48060-8500
(810) 987-1400
(810) 987-1349
Mailing address
1175 THOMAS EDISON DR, PORT HURON, MI 48060-8500
(810) 987-1400
(810) 987-1349
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
JS019200
MI
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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