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Individual

DR. JERRY BURGESS MULDER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS PLC

Contact information

Practice address
515 MICHIGAN ST NE, SUITE 202, GRAND RAPIDS, MI 49503-5721
(616) 458-0631
(616) 458-4065
Mailing address
515 MICHIGAN ST, SUITE 202, GRAND RAPIDS, MI 49503
(616) 458-0631
(616) 458-4065

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D126890
MI

Other

Enumeration date
03/23/2007
Last updated
07/08/2015
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