# DOUGLAS A BLEYENBURG DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Office
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083624662
- **Authorized official:** DR. DOUGLAS A BLEYENBURG DDS (PRESIDENT)
- **Authorized official phone:** (616) 392-2302

## Contact information

- **Practice address:** 170 COLLEGE AVE, \#220, HOLLAND, MI 49423
- **Practice address phone:** (616) 392-2302
- **Practice address fax:** (616) 392-9060
- **Mailing address:** 170 COLLEGE AVE, \#220, HOLLAND, MI 49423
- **Mailing address phone:** (616) 392-2302
- **Mailing address fax:** (616) 392-9060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 16773 | MI | Yes |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 08/22/2020