Organization
GRAND RIDGE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DANIEL LEWIS DDS (PROPRIETOR)
(616) 447-7800
Entity
Organization
Contact information
Practice address
3350 GRAND RIDGE DR NE, GRAND RAPIDS, MI 49525-7071
(616) 447-7800
(616) 447-9611
Mailing address
3350 GRAND RIDGE DR NE, GRAND RAPIDS, MI 49525-7071
(616) 447-7800
(616) 447-9611
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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