# HARVESTER DENTAL

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

## Provider details

- **NPI number:** 1730539818
- **Authorized official:** RACHEL BRUEN (HUMAN RESOURCES)
- **Authorized official phone:** (616) 363-1136

## Contact information

- **Practice address:** 2755 FULLER AVE NE, GRAND RAPIDS, MI 49505-3785
- **Practice address phone:** (616) 363-1136
- **Mailing address:** 2755 FULLER AVE NE, GRAND RAPIDS, MI 49505-3785
- **Mailing address phone:** (616) 363-1136

## Taxonomy

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

## Other

- **Enumeration date:** 06/20/2016
- **Last updated:** 06/20/2016