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Organization
MI SMILES DENTAL GRAND RAPIDS SE PLC
Active
Organization
MI SMILES DENTAL GRAND RAPIDS SE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ROGERS (DIRECTOR OF FINANCE)
(616) 379-4013
Entity
Organization
Contact information
Practice address
2100 RAYBROOK ST SE STE 106, GRAND RAPIDS, MI 49546-5783
(616) 942-2870
Mailing address
3250 CENTRAL BLVD, HUDSONVILLE, MI 49426-1439
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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