# MATTHEW R VANDERLAAN DDS PLLC

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

## Provider details

- **NPI number:** 1083129910
- **Authorized official:** DR. MATTHEW RYAN VANDERLAAN DDS (OWNER/DENTIST)
- **Authorized official phone:** (616) 455-7310

## Contact information

- **Practice address:** 820 84TH STREET SW, BYRON CENTER, MI 49315-9458
- **Practice address phone:** (616) 455-7310
- **Practice address fax:** (616) 455-0332
- **Mailing address:** 820 84TH STREET SW, BYRON CENTER, MI 49315-9458
- **Mailing address phone:** (616) 455-7310
- **Mailing address fax:** (616) 455-0332

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901020014 | MI | Yes |
| 122300000X | Dentist | 2901021039 | MI | — |

## Other

- **Enumeration date:** 12/14/2017
- **Last updated:** 12/14/2017