Healthcare Provider Details

I. General information

NPI: 1720870348
Provider Name (Legal Business Name): KH SEAWAY DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 MILITARY ST
PORT HURON MI
48060-6664
US

IV. Provider business mailing address

2435 MILITARY ST
PORT HURON MI
48060-6664
US

V. Phone/Fax

Practice location:
  • Phone: 734-634-4459
  • Fax:
Mailing address:
  • Phone: 810-982-5334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK W. HOULIHAN
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 734-634-4459