| Healthy Smile Plc | |
|
2021 44th St Sw Grand Rapids MI 49508 | |
| (616) 281-8338 | |
| (616) 281-1162 |
| Full Name | Healthy Smile Plc |
|---|---|
| Speciality | Dentist |
| Location | 2021 44th St Sw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Suzzette Ona (OWNER/DENTIST) |
| Authorized Official Contact | 6162818338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Smile Plc Po Box 8228 Kentwood MI 49518-8228 Ph: (616) 281-8338 | Healthy Smile Plc 2021 44th St Sw Grand Rapids MI 49508 Ph: (616) 281-8338 |
| NPI Number | 1821471616 |
|---|---|
| Provider Enumeration Date | 06/30/2015 |
| Last Update Date | 06/30/2015 |
| Medicare PECOS PAC ID | 7517271026 |
|---|---|
| Medicare Enrollment ID | O20150728005506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821471616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17705 (Michigan) | Primary |
| Provider Name | Suzzette L Ona |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194942557 PECOS PAC ID: 3375567365 Enrollment ID: I20150728005618 |
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