MEDICARE: KH SEAWAY DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1720870348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KH SEAWAY DENTAL PLLC

Provider Business Mailing Address
First Line	:	2435 MILITARY ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-6664
Country	:	US
Telephone Number	:	810-982-5334
Fax Number	:

Provider Business Practice Location Address
First Line	:	2435 MILITARY ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-6664
Country	:	US
Telephone Number	:	734-634-4459
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. PATRICK W. HOULIHAN
Credential	:	DDS
Telephone Number	:	734-634-4459

Provider Enumeration Date	:	05/20/2025
Last Update Date	:	05/20/2025

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