| NPI | 1336901826 |
|---|---|
| Doing Business As | PORTAGE DENTAL OFFICE |
| Entity Type | Organization |
| Authorized Contact | RAHAF KANAWATI Owner 269-276-6602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |