| Stuart Pettijohn Dds Pllc | |
|
4500 Cascade Rd Se Ste 100 Grand Rapids MI 49546-3665 | |
| (616) 942-8301 | |
| Not Available |
| Full Name | Stuart Pettijohn Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 4500 Cascade Rd Se Ste 100, Grand Rapids, Michigan |
| Authorized Official Name and Position | Stuart Pettijohn (DENTIST) |
| Authorized Official Contact | 6168900750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stuart Pettijohn Dds Pllc 4500 Cascade Rd Se Ste 100 Grand Rapids MI 49546-3665 Ph: (616) 942-8301 | Stuart Pettijohn Dds Pllc 4500 Cascade Rd Se Ste 100 Grand Rapids MI 49546-3665 Ph: (616) 942-8301 |
| NPI Number | 1295254035 |
|---|---|
| Provider Enumeration Date | 09/13/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295254035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2901020216 (Michigan) | Primary |
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