Organization
OROURKE AND WONDERLY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORA WONDERLY DDS (DENTIST)
(616) 455-7930
Entity
Organization
Contact information
Practice address
4250 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-2699
(616) 455-7930
(616) 455-9952
Mailing address
4250 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-2699
(616) 455-7930
(616) 455-9952
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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