| Eastern Dental Plc | |
|
2426 Burton St Se Grand Rapids MI 49546-4898 | |
| (616) 974-0991 | |
| (616) 974-0920 |
| Full Name | Eastern Dental Plc |
|---|---|
| Speciality | Dentist |
| Location | 2426 Burton St Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Kourosh B Amiri (OWNER/DENTIST) |
| Authorized Official Contact | 6167247376 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Dental Plc 2426 Burton St Se Grand Rapids MI 49546-4898 Ph: (616) 974-0991 | Eastern Dental Plc 2426 Burton St Se Grand Rapids MI 49546-4898 Ph: (616) 974-0991 |
| NPI Number | 1033308952 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033308952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901018678 (Michigan) | Primary |
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