Wilson Dental Care Gr Pc

NPI 1598007379 - Dentist - 1223G0001X

NPI Details
NPI 1598007379
Enumeration Date 03/20/2013
Last Updated 03/20/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name KATHI A KATHI
Position OWNER
Phone (616) 454-1482
Fax (616) 454-4422
Practice Location
1625 DIAMOND AVE NE
STE 1
GRAND RAPIDS MI, 49505-4887, US
Phone (616) 454-1482
Fax (616) 454-4422
Business Location
1625 DIAMOND AVE NE
STE 1
GRAND RAPIDS MI, 49505-4887, US
Phone (616) 454-1482
Fax (616) 454-4422
Toxanomy
Taxonomy Code 1223G0001X
License State Michigan
License Number 17948
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According to our database, Wilson Dental Care Gr Pc NPI is 1598007379, taxonomy code is 1223G0001X and license number is 17948, license state is located at Michigan. Wilson Dental Care Gr Pc physically located at 1625 Diamond Ave Ne, Grand Rapids MI, 49505-4887. NPI Number 1033115704 has the healthcare provider type.

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1598007379 NPI number is provided on an as is basis without warranty of any kind. 1598007379 is maintained by the National Plan & Provider Enumeration System. The contents of Wilson Dental Care Gr Pc are for informational purposes only.