# DENT-U-CENTER PC

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

## Provider details

- **NPI number:** 1811152358
- **Authorized official:** DR. LEE DAVID FREDERICKSON DDS (OWNER)
- **Authorized official phone:** (616) 534-5602

## Contact information

- **Practice address:** 3004 28TH ST SW, GRANDVILLE, MI 49418-2704
- **Practice address phone:** (616) 534-5602
- **Practice address fax:** (616) 534-4538
- **Mailing address:** 3004 28TH ST SW, GRANDVILLE, MI 49418-2704
- **Mailing address phone:** (616) 534-5602
- **Mailing address fax:** (616) 534-4538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 09607 | MI | Yes |
| 122300000X | Dentist | 12554 | MI | — |

## Other

- **Enumeration date:** 07/24/2008
- **Last updated:** 07/24/2008