Organization
MIDWEST IMPLANT SURGERY CENTER
Active
Parent organization
MIDWEST FAMILY DENTAL CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST FAMILY DENTAL CARE
Authorized official
MS. BRANDYNN MARIE BEAVER (ADMIN)
(616) 457-2299
Entity
Organization
Contact information
Practice address
2064 BALDWIN ST, JENISON, MI 49428-8773
(616) 457-2299
Mailing address
2064 BALDWIN ST, JENISON, MI 49428-8773
(616) 457-2299
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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