Individual
DR. BRENT A MEDEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9021 N RODGERS CT SE, SUITE E, CALEDONIA, MI 49316-7649
(616) 891-1400
Mailing address
7090 HICKORY POINT DR, PORTAGE, MI 49024-4039
(269) 760-5505
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2901021310
MI
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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