| Mark A Osenieks Dds Pc | |
|
O-11225 Tallmadge Woods Dr Nw Grand Rapids MI 49534-6313 | |
| (616) 453-0002 | |
| Not Available |
| Full Name | Mark A Osenieks Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | O-11225 Tallmadge Woods Dr Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Mark A Osenieks (PRESIDENT) |
| Authorized Official Contact | 6164530002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A Osenieks Dds Pc O-11225 Tallmadge Woods Dr Nw Grand Rapids MI 49534-6313 Ph: (616) 453-0002 | Mark A Osenieks Dds Pc O-11225 Tallmadge Woods Dr Nw Grand Rapids MI 49534-6313 Ph: (616) 453-0002 |
| NPI Number | 1134425408 |
|---|---|
| Provider Enumeration Date | 02/04/2011 |
| Last Update Date | 02/04/2011 |
| Medicare PECOS PAC ID | 5698732972 |
|---|---|
| Medicare Enrollment ID | O20041217000803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134425408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901016297 (Michigan) | Primary |
| Provider Name | Mark A Osenieks |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1912062902 PECOS PAC ID: 1951368232 Enrollment ID: I20041217000817 |
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