NPI 1114563012

Harborside Dental PLLC

Organisation General Practice Dentistry Traverse City, MI

Practice location

Address: 13300 S West Bay Shore Dr STE 1, Traverse City, MI 49684-5571
Phone: (231) 946-0207

Authorised official

Name: Mark David Krull
Title: Partner
Phone: (231) 946-0207

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X

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Registry record

NPI: 1114563012
Entity type: Organization
NPI issued: 26 Nov 2019
Record last updated: 26 Nov 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.