| Rivertown Dental Excellence | |
|
4565 Wilson Ave Sw Suite 2a Grandville MI 49418-2371 | |
| (616) 538-0770 | |
| (616) 538-0359 |
| Full Name | Rivertown Dental Excellence |
|---|---|
| Speciality | Dentist |
| Location | 4565 Wilson Ave Sw, Grandville, Michigan |
| Authorized Official Name and Position | Jared M Van Ittersum (OWNER) |
| Authorized Official Contact | 6165380770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivertown Dental Excellence 4565 Wilson Ave Sw Suite 2a Grandville MI 49418-2371 Ph: (616) 538-0770 | Rivertown Dental Excellence 4565 Wilson Ave Sw Suite 2a Grandville MI 49418-2371 Ph: (616) 538-0770 |
| NPI Number | 1558633909 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 02/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558633909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901019772 (Michigan) | Primary |
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