Eastern Dental Plc

NPI 1033308952 - Dentist - 122300000X

NPI Details
NPI 1033308952
Enumeration Date 10/16/2007
Last Updated 06/17/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KOUROSH B KOUROSH
Position OWNER/DENTIST
Phone (616) 974-0991
Fax (616) 974-0920
Practice Location
2426 BURTON ST SE
GRAND RAPIDS MI, 49546-4898, US
Phone (616) 974-0991
Fax (616) 974-0920
Business Location
2426 BURTON ST SE
GRAND RAPIDS MI, 49546-4898, US
Phone (616) 974-0991
Fax (616) 974-0920
Toxanomy
Taxonomy Code 122300000X
License State Michigan
License Number 2901018678
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According to our database, Eastern Dental Plc NPI is 1033308952, taxonomy code is 122300000X and license number is 2901018678, license state is located at Michigan. Eastern Dental Plc physically located at 2426 Burton St Se, Grand Rapids MI, 49546-4898. NPI Number 1033115704 has the healthcare provider type.

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1033308952 NPI number is provided on an as is basis without warranty of any kind. 1033308952 is maintained by the National Plan & Provider Enumeration System. The contents of Eastern Dental Plc are for informational purposes only.