| NPI | 1760804983 |
|---|---|
| Doing Business As | PERIODONTIC ASSOCIATES OF PORT HURON |
| Entity Type | Organization |
| Authorized Contact | JASON GEORGE SOUYIAS Partner 810-987-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI JS019200) |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |