# ORAL & MAXILLOFACIAL SURGERY OF GREATER GRAND RAPIDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bradley G. VanHoose
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295375137
- **Authorized official:** BRADLEY G VANHOOSE GARRETT VANHOOSE DDS MS (ORAL SURGEON)
- **Authorized official phone:** (616) 891-1700

## Contact information

- **Practice address:** 9021 N RODGERS CT SE STE A, CALEDONIA, MI 49316-7650
- **Practice address phone:** (616) 891-1700
- **Practice address fax:** (616) 891-9306
- **Mailing address:** 9021 N RODGERS CT SE STE A, CALEDONIA, MI 49316-7650
- **Mailing address phone:** (616) 891-1700
- **Mailing address fax:** (616) 891-9306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2020
- **Last updated:** 01/08/2020