Spring Lake Family Dentistry
Clinic/Center, Dental in Spring Lake, MI. Organization (NPI-2).
NPI number1396136271
StatusActive
Last updated in NPPESFeb 12, 2015
Details
- NPI
- 1396136271
- Entity type
- Organization (NPI-2)
- Legal business name
- Spring Lake Family Dentistry
- Organization subpart
- No
- Enumeration date
- Feb 12, 2015
- Last updated
- Feb 12, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | E1557U | MI | Yes |
Practice location
102 S Buchanan StSte A
Spring Lake, MI 49456-2090
Phone 616-846-5690 · Fax 616-846-6160
Mailing address
102 S Buchanan StSte A
Spring Lake, MI 49456-2090
Phone 616-846-5690 · Fax 616-846-6160
Authorized official
Jared M Vanittersum
Owner/Dentist
6168465690
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