Organization
EDWARD D YOUNG DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD D YOUNG DDS (PRESIDENT)
(616) 791-0230
Entity
Organization
Contact information
Practice address
4310 LEONARD NW, GRAND RAPIDS, MI 49534
(616) 791-0230
Mailing address
4310 LEONARD NW, GRAND RAPIDS, MI 49534
(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
10/02/2006
Last updated
08/22/2020
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