# RICHARD C. ROBERTSON DDS PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Caledonia Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437302551
- **Authorized official:** DR. RICHARD CLYDE ROBERTSON DDS (MEMBER)
- **Authorized official phone:** (616) 891-8141

## Contact information

- **Practice address:** 9090 S RODGERS CT SE, CALEDONIA, MI 49316-8052
- **Practice address phone:** (616) 891-8141
- **Practice address fax:** (616) 891-8142
- **Mailing address:** 9090 S RODGERS CT SE, CALEDONIA, MI 49316-8052
- **Mailing address phone:** (616) 891-8141
- **Mailing address fax:** (616) 891-8142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 13197 | MI | Yes |
| 122300000X | Dentist | 19398 | MI | — |

## Other

- **Enumeration date:** 11/03/2008
- **Last updated:** 11/03/2008