# CHRISTIAN VERMEULEN DDS PLC

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

## Provider details

- **NPI number:** 1396869020
- **Authorized official:** DR. CHRISTIAN L VERMEULEN DDS (DENTIST PRESIDENT)
- **Authorized official phone:** (616) 949-3500

## Contact information

- **Practice address:** 4940 CASCADE RD SE STE 010, GRAND RAPIDS, MI 49546-3723
- **Practice address phone:** (616) 949-3500
- **Practice address fax:** (616) 949-9931
- **Mailing address:** 4940 CASCADE RD SE STE 010, GRAND RAPIDS, MI 49546-3723
- **Mailing address phone:** (616) 949-3500
- **Mailing address fax:** (616) 949-9931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 29001018102 | MI | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 08/22/2020