| Cedarrock Dental Care Pc | |
|
4655 14 Mile Rd Ne Rockford MI 49341 | |
| (616) 866-4461 | |
| (616) 696-3420 |
| Full Name | Cedarrock Dental Care Pc |
|---|---|
| Speciality | Dentist |
| Location | 4655 14 Mile Rd Ne, Rockford, Michigan |
| Authorized Official Name and Position | Richard L Jeruzal (PRESIDENT) |
| Authorized Official Contact | 6168664461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedarrock Dental Care Pc 4655 14 Mile Rd Ne Rockford MI 49341 Ph: (616) 866-4461 | Cedarrock Dental Care Pc 4655 14 Mile Rd Ne Rockford MI 49341 Ph: (616) 866-4461 |
| NPI Number | 1972571362 |
|---|---|
| Provider Enumeration Date | 03/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972571362 | NPI | - | NPPES |
| 4051090 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 10232 (Michigan) | Primary |
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