| Dent-u-center Pc | |
|
3004 28th St Sw Grandville MI 49418-2704 | |
| (616) 534-5602 | |
| (616) 534-4538 |
| Full Name | Dent-u-center Pc |
|---|---|
| Speciality | Dentist |
| Location | 3004 28th St Sw, Grandville, Michigan |
| Authorized Official Name and Position | Lee David Frederickson (OWNER) |
| Authorized Official Contact | 6165345602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dent-u-center Pc 3004 28th St Sw Grandville MI 49418-2704 Ph: (616) 534-5602 | Dent-u-center Pc 3004 28th St Sw Grandville MI 49418-2704 Ph: (616) 534-5602 |
| NPI Number | 1811152358 |
|---|---|
| Provider Enumeration Date | 07/24/2008 |
| Last Update Date | 07/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811152358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 09607 (Michigan) | Primary |
| 122300000X | Dentist | 12554 (Michigan) | Secondary |
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