# CASCADE FAMILY DENTISTRY PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** esmiles
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548213911
- **Authorized official:** DR. ROSANNE SCIGLIANO EGGLESTON DDS (PRESIDENT)
- **Authorized official phone:** (616) 682-0147

## Contact information

- **Practice address:** 6883 CASCADE RD SE, GRAND RAPIDS, MI 49546-6899
- **Practice address phone:** (616) 682-0147
- **Mailing address:** 6883 CASCADE RD SE, GRAND RAPIDS, MI 49546-6899
- **Mailing address phone:** (616) 682-0147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2901015835 | MI | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | J800194 | BLUE CROSS BLUE SHIELD | MI |