| Caledonia Dental | |
|
9090 S Rodgers Ct Se Caledonia MI 49316-8052 | |
| (616) 891-8141 | |
| (616) 891-8142 |
| Full Name | Caledonia Dental |
|---|---|
| Speciality | Dentist |
| Location | 9090 S Rodgers Ct Se, Caledonia, Michigan |
| Authorized Official Name and Position | Richard Clyde Robertson (MEMBER) |
| Authorized Official Contact | 6168918141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caledonia Dental 9090 S Rodgers Ct Se Caledonia MI 49316-8052 Ph: (616) 891-8141 | Caledonia Dental 9090 S Rodgers Ct Se Caledonia MI 49316-8052 Ph: (616) 891-8141 |
| NPI Number | 1437302551 |
|---|---|
| Provider Enumeration Date | 11/03/2008 |
| Last Update Date | 11/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437302551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 13197 (Michigan) | Primary |
| 122300000X | Dentist | 19398 (Michigan) | Secondary |
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