| Grandville Dental Health Center Pc | |
|
4050 Del Mar Dr Sw Suite B Wyoming MI 49418-8870 | |
| (616) 531-0360 | |
| (616) 531-2810 |
| Full Name | Grandville Dental Health Center Pc |
|---|---|
| Speciality | Dentist |
| Location | 4050 Del Mar Dr Sw, Wyoming, Michigan |
| Authorized Official Name and Position | Larissa Kyle Bishop (PRESIDENT) |
| Authorized Official Contact | 6165310360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grandville Dental Health Center Pc 4050 Del Mar Dr Sw Suite B Wyoming MI 49418-8870 Ph: (616) 531-0360 | Grandville Dental Health Center Pc 4050 Del Mar Dr Sw Suite B Wyoming MI 49418-8870 Ph: (616) 531-0360 |
| NPI Number | 1881843878 |
|---|---|
| Provider Enumeration Date | 09/15/2008 |
| Last Update Date | 01/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881843878 | NPI | - | NPPES |
| 4487030 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901019378 (Michigan) | Primary |
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