Harbor Dental

LBN: Harbor Dental
Harbor Dental is an health care organization with primary practice located at 143 E Main , Benton Harbor MI 49022. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Harbor Dental can be contacted via phone (269) 927-1313, or through Potts, Glenda J via phone (269) 927-1313.

Contact Information

Primary practice address
143 E Main Benton Harbor MI 49022
Phone: (269) 927-1313
Fax: (269) 934-9447
Website:
Map and Directions
Authorized official contact:
Name: Potts, Glenda J RDA CDA
Phone: (269) 927-1313

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X

Profile Details

NPI number 1992712061
LBN Legal business name Harbor Dental
DBA Doing business as
Authorized official Potts, Glenda J RDA CDA
Entity Organization
Organization subpart 1 No
Enumeration date Aug 2nd, 2006
Last updated Aug 22nd, 2020 - about 6 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 1992712061 NPPES
Michigan MEDICAID 4545920

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