Organization
TOUGH TEETH & GREAT GUMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELIZABETH BROEKSTRA RDH (DIRECTOR)
(616) 460-6369
Entity
Organization
Contact information
Practice address
1866 10 MILE RD NE, COMSTOCK PARK, MI 49321-9669
(616) 460-6369
Mailing address
1866 10 MILE RD NE, COMSTOCK PARK, MI 49321-9669
(616) 460-6369
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
2901010721
MI
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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