# MARK A OSENIEKS DDS PC

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

## Provider details

- **NPI number:** 1134425408
- **Authorized official:** MARK A OSENIEKS (PRESIDENT)
- **Authorized official phone:** (616) 453-0002

## Contact information

- **Practice address:** O-11225 TALLMADGE WOODS DR NW, GRAND RAPIDS, MI 49534-6313
- **Practice address phone:** (616) 453-0002
- **Mailing address:** O-11225 TALLMADGE WOODS DR NW, GRAND RAPIDS, MI 49534-6313
- **Mailing address phone:** (616) 453-0002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901016297 | MI | Yes |

## Other

- **Enumeration date:** 02/04/2011
- **Last updated:** 02/04/2011