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Individual
DR. DAN J VANDERMEULEN
Active
Individual
DR. DAN J VANDERMEULEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
10199
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1953960010
BCBS OF MI FOR MED CLAIMS
MI
Enumeration date
08/18/2006
Last updated
07/08/2007
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