# GRAND RAPIDS DENTISTRY PLC

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

## Provider details

- **NPI number:** 1720486731
- **Authorized official:** GREG MCGLAUN (MANAGER)
- **Authorized official phone:** (616) 719-8000

## Contact information

- **Practice address:** 2003 BURTON ST SE, GRAND RAPIDS, MI 49506-4600
- **Practice address phone:** (616) 243-8936
- **Mailing address:** 2003 BURTON ST SE, GRAND RAPIDS, MI 49506-4600
- **Mailing address phone:** (616) 243-8936

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 18383 | MI | Yes |

## Other

- **Enumeration date:** 12/08/2014
- **Last updated:** 12/08/2014