# MITUS-ROSENDALL D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063689362
- **Authorized official:** ROBIN MARIE SANDRETTO (OFFICE MANAGER)
- **Authorized official phone:** (616) 363-9277

## Contact information

- **Practice address:** 4829 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-9747
- **Practice address phone:** (616) 363-9277
- **Mailing address:** 4829 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-9747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 14130 | MI | Yes |

## Other

- **Enumeration date:** 05/15/2008
- **Last updated:** 05/15/2008