| 36th Street Dental Associates | |
|
630 36th Street Sw Grand Rapids MI 49509 | |
| (616) 538-4330 | |
| (616) 538-5353 |
| Full Name | 36th Street Dental Associates |
|---|---|
| Speciality | Dentist |
| Location | 630 36th Street Sw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Eric John Foster (DENTIST) |
| Authorized Official Contact | 6165384330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 36th Street Dental Associates 630 36th Street Sw Grand Rapids MI 49509 Ph: (616) 538-4330 | 36th Street Dental Associates 630 36th Street Sw Grand Rapids MI 49509 Ph: (616) 538-4330 |
| NPI Number | 1689752537 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689752537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901018395 (Michigan) | Primary |
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