Suzanne K Port in Holland - Pediatric Dentistry
Suzanne K Port - NPI 1700925690
Suzanne K Port is a Pediatric Dentistry in Holland, Michigan. Suzanne K Port practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Suzanne K Port is 1700925690. The last update date is 2007-07-08.
Suzanne K Port's current location address is 291 W Lakewood Blvd, Holland, Michigan. You can contact this provider via phone number 6163921100 and fax number 6163961117. The mailing address for Suzanne K Port is 291 W Lakewood Blvd, Holland, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Suzanne K Port |
|---|---|
| Address | 291 W Lakewood Blvd, Holland, Michigan |
| Phone Number | 6163921100 |
| Fax Number | 6163961117 |
| Sole Proprietor | N |
| Credentials | DDS MS |
NPI Number Detail
| NPI Number | 1700925690 |
|---|---|
| Provider Enumeration Date | 2007-02-06 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 291 W Lakewood Blvd |
|---|---|
| City | Holland |
| State | Michigan (MI) |
| Post Code | 49424 |
| Phone Number | 6163921100 |
| Fax Number | 6163961117 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 2901018529 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique 10-digit identifier code issued to Suzanne K Port by the Centers for Medicare & Medicaid Services?
The Suzanne K Port has been assigned the NPI (National Provider Identifier) 1700925690 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Suzanne K Port?
The Suzanne K Port is physically situated at 291 W Lakewood Blvd, in the city of Holland, state of MI, with the postal code 49424.
What is the Suzanne K Port's specialty and taxonomy code?
The Suzanne K Port's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
When was the Suzanne K Port's 1700925690 issued?
The Suzanne K Port's 1700925690 was issued on 2007-02-06.
When was the information regarding Suzanne K Port, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Suzanne K Port, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.