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Organization
WESTNEDGE FAMILY DENTISTRY
Active
Organization
WESTNEDGE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CHARLES SACKETT D.D.S (DENTIST)
(269) 345-8893
Entity
Organization
Contact information
Practice address
3907 S WESTNEDGE AVE, KALAMAZOO, MI 49008-3187
(269) 345-8893
(269) 492-1710
Mailing address
3907 S WESTNEDGE AVE, KALAMAZOO, MI 49008-3187
(269) 345-8893
(269) 492-1710
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14741
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14741
SACKETT-DELTA DENTAL #
MI
01
—
16115
MI DELTA DENTAL # JUNGBLU
MI
01
—
17761
MASON-DELTA DENTAL MI
MI
01
—
2901014741
LICENSE
MI
01
—
2901016115
TIM JUNGBLUT STATE LICENS
MI
01
—
2901017761
LICENSE #
MI
05
—
3273324
—
MI
05
—
3273360
—
MI
Enumeration date
01/02/2007
Last updated
08/22/2020
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