| Grand River Endodontics Pc | |
|
4211 Parkway Place Dr Sw Suite 104 Grandville MI 49418-2695 | |
| (616) 249-3500 | |
| (616) 249-3502 |
| Full Name | Grand River Endodontics Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 4211 Parkway Place Dr Sw, Grandville, Michigan |
| Authorized Official Name and Position | Sarah Lennan Masterson (OWNER/ENDODONTIST) |
| Authorized Official Contact | 6162493500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand River Endodontics Pc 4211 Parkway Place Dr Sw Suite 104 Grandville MI 49418-2695 Ph: (616) 249-3500 | Grand River Endodontics Pc 4211 Parkway Place Dr Sw Suite 104 Grandville MI 49418-2695 Ph: (616) 249-3500 |
| NPI Number | 1518360304 |
|---|---|
| Provider Enumeration Date | 10/07/2014 |
| Last Update Date | 09/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518360304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 2901019457 (Michigan) | Primary |
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