Organization
OSHTEMO FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KEVIN BANNOW D.D.S. (PRESIDENT)
(269) 372-1042
Entity
Organization
Contact information
Practice address
5917 STADIUM DR, KALAMAZOO, MI 49009-3017
(269) 372-1042
(269) 372-9962
Mailing address
5917 STADIUM DR, KALAMAZOO, MI 49009-3017
(269) 372-1042
(269) 372-9962
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901012099
MI
Other
Enumeration date
11/16/2006
Last updated
08/22/2020
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