# VANDERLUGT DENTAL

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

## Provider details

- **NPI number:** 1720275167
- **Authorized official:** DAVID F VANDERLUGT (DDS)
- **Authorized official phone:** (616) 455-8400

## Contact information

- **Practice address:** 2008 EASTCASTLE DR SE STE C, GRAND RAPIDS, MI 49508-8874
- **Practice address phone:** (616) 455-8400
- **Practice address fax:** (616) 455-4283
- **Mailing address:** 2008 EASTCASTLE DR SE STE C, GRAND RAPIDS, MI 49508-8874
- **Mailing address phone:** (616) 455-8400
- **Mailing address fax:** (616) 455-4283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | L732419 | MI | Yes |

## Other

- **Enumeration date:** 10/01/2007
- **Last updated:** 10/01/2007