# JOHN J STEPANOVICH DDS

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

## Provider details

- **NPI number:** 1629261235
- **Authorized official:** DR. JOHN J STEPANOVICH DDS (DENTIST)
- **Authorized official phone:** (616) 459-1267

## Contact information

- **Practice address:** 260 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4597
- **Practice address phone:** (616) 459-1267
- **Practice address fax:** (616) 459-0673
- **Mailing address:** 260 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4597
- **Mailing address phone:** (616) 459-1267
- **Mailing address fax:** (616) 459-0673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 07553 | MI | Yes |

## Other

- **Enumeration date:** 08/27/2007
- **Last updated:** 08/27/2007