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Organization

PERIODONTIC ASSOCIATES OF PORT HURON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK KOENEN SETTER D.D.S., M.S. (OWNER)
(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
MS012152
MI

Other

Enumeration date
08/30/2011
Last updated
08/30/2011
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