# 44 WEST DENTAL PROFESSIONALS PC

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

## Provider details

- **NPI number:** 1275914673
- **Authorized official:** JASON C DOUBLESTEIN DDS (CO-OWNER)
- **Authorized official phone:** (616) 530-2200

## Contact information

- **Practice address:** 4330 44TH ST SW STE 105, GRANDVILLE, MI 49418-2349
- **Practice address phone:** (616) 530-2200
- **Practice address fax:** (616) 530-8250
- **Mailing address:** 4330 44TH ST SW STE 105, GRANDVILLE, MI 49418-2349
- **Mailing address phone:** (616) 530-2200
- **Mailing address fax:** (616) 530-8250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901018806 | MI | Yes |
| 122300000X | Dentist | 2901020644 | MI | — |

## Other

- **Enumeration date:** 06/11/2015
- **Last updated:** 10/09/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1386760072 | DENTIST | MI |
| 01 | — | 1578823993 | DENTIST | MI |
| 01 | — | 1760829444 | DENTIST | MI |