# PROFESSIONAL DENTALCARE ASSOCIATES, PLLC

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

## Provider details

- **NPI number:** 1467628909
- **Authorized official:** ADELE DIANE GRAY (DENTIST/OWNER)
- **Authorized official phone:** (616) 363-3821

## Contact information

- **Practice address:** 3303 GRAND RIDGE DR NE, GRAND RAPIDS, MI 49525-7033
- **Practice address phone:** (616) 363-3821
- **Mailing address:** 3303 GRAND RIDGE DR NE, GRAND RAPIDS, MI 49525-7033
- **Mailing address phone:** (616) 363-3821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/05/2008
- **Last updated:** 05/05/2008