Pediatric Dental Specilaist, P.C

LBN: Pediatric Dental Specilaist, P.C
Pediatric Dental Specilaist, P.C is an health care organization with primary practice located at 1026 Superior St , Port Huron MI 48060-3748. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Pediatric Dental Specilaist, P.C can be contacted via phone (810) 987-5040, or through Woodward, Kacey A via phone (810) 987-5040.

Contact Information

Primary practice address
1026 Superior St Port Huron MI 48060-3748
Phone: (810) 987-5040
Fax: (810) 987-9499
Website:
Map and Directions
Authorized official contact:
Name: Woodward, Kacey A
Phone: (810) 987-5040

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1255063244
LBN Legal business name Pediatric Dental Specilaist, P.C
DBA Doing business as
Authorized official Woodward, Kacey A
Entity Organization
Organization subpart 1 No
Enumeration date Jun 28th, 2022
Last updated Jul 26th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255063244 NPPES
Michigan MEDICAID 4032586

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