Individual
DR. EDWARD D YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4310 LEONARD ST NW, GRAND RAPIDS, MI 49534-8447
(616) 791-0230
Mailing address
4310 LEONARD ST NW, GRAND RAPIDS, MI 49534-8447
(616) 791-0230
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901013995
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4563730
—
MI
Enumeration date
02/15/2007
Last updated
07/09/2007
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