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Organization
WEST SIDE DENTAL PC
Active
Organization
WEST SIDE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLYSON BURGESS MULDER DMD (DENTIST)
(616) 453-5331
Entity
Organization
Contact information
Practice address
515 MICHIGAN ST NE STE 202, GRAND RAPIDS, MI 49503-5721
(616) 453-5331
(616) 453-9235
Mailing address
515 MICHIGAN ST NE STE 202, GRAND RAPIDS, MI 49503-5721
(616) 453-5331
(616) 453-9235
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901020749
MI
Other
Enumeration date
05/09/2016
Last updated
06/08/2016
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