# PETER A GARCHOW DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental South
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912666132
- **Authorized official:** WENDY VANTIL (ACCOUNT MANAGER)
- **Authorized official phone:** (616) 538-9020

## Contact information

- **Practice address:** 630 36TH ST SW, GRAND RAPIDS, MI 49509-4100
- **Practice address phone:** (616) 538-9020
- **Practice address fax:** (616) 538-5353
- **Mailing address:** 630 36TH ST SW, GRAND RAPIDS, MI 49509-4100

## Taxonomy

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

## Other

- **Enumeration date:** 12/15/2021
- **Last updated:** 12/15/2021