# JUSTIN P TERRY DDS PLLC

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

## Provider details

- **NPI number:** 1750243853
- **Authorized official:** DR. JUSTIN PARK TERRY DDS (OWNER)
- **Authorized official phone:** (231) 799-5665

## Contact information

- **Practice address:** 504 WATER ST, MANISTEE, MI 49660-1544
- **Practice address phone:** (231) 723-7957
- **Mailing address:** 1783 BLAKETON DR, GRAND RAPIDS, MI 49534-1702
- **Mailing address phone:** (231) 799-5665

## Taxonomy

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

## Other

- **Enumeration date:** 11/26/2025
- **Last updated:** 11/26/2025