# MATTAWAN FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1124836531
- **Authorized official:** DR. JONATHAN VANDENBURGH DDS (OWNER)
- **Authorized official phone:** (269) 568-2609

## Contact information

- **Practice address:** 56400 CITY CENTER CIR, MATTAWAN, MI 49071-8380
- **Practice address phone:** (269) 568-2609
- **Mailing address:** 56400 CITY CENTER CIR, MATTAWAN, MI 49071-8380
- **Mailing address phone:** (269) 568-2609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 124Q00000X | Dental Hygienist | — | — | — |

## Other

- **Enumeration date:** 12/19/2024
- **Last updated:** 12/19/2024