Grandville Pediatric Dentristry in Grandville - Pediatric Dentistry
Grandville Pediatric Dentristry - NPI 1891718284
Grandville Pediatric Dentristry is a Pediatric Dentistry in Grandville, Michigan. Grandville Pediatric Dentristry practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Grandville Pediatric Dentristry is 1891718284. The last update date is 2020-08-22.
Grandville Pediatric Dentristry's current location address is 3131 44th St Sw, Grandville, Michigan. You can contact this provider via phone number 6165313430. The mailing address for Grandville Pediatric Dentristry is 3131 44th St Sw, Grandville, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Grandville Pediatric Dentristry |
|---|---|
| Address | 3131 44th St Sw, Grandville, Michigan |
| Phone Number | 6165313430 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Demeter Brian Michael |
| Credentials | DDS |
| Telephone Number | 6165313430 |
NPI Number Detail
| NPI Number | 1891718284 |
|---|---|
| Provider Enumeration Date | 2006-07-26 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 3131 44th St Sw |
|---|---|
| City | Grandville |
| State | Michigan (MI) |
| Post Code | 494182684 |
| Phone Number | 6165313430 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 17118 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique 10-digit identification code issued to Grandville Pediatric Dentristry by the Centers for Medicare & Medicaid Services?
The Grandville Pediatric Dentristry has been assigned the NPI (National Provider Identifier) 1891718284 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Grandville Pediatric Dentristry's facilities are geographically located?
The facilities of Grandville Pediatric Dentristry are physically situated at the following location: 3131 44Th St Sw, Grandville, MI, 494182684.
What is the Grandville Pediatric Dentristry's specialty and taxonomy code?
The Grandville Pediatric Dentristry's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1891718284 to Grandville Pediatric Dentristry?
The Centers for Medicare & Medicaid Services originally issued the 1891718284 to Grandville Pediatric Dentristry on 2006-07-26.
As of what date were the details related to Grandville Pediatric Dentristry most recently updated or revised?
The information pertaining to Grandville Pediatric Dentristry, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.