Organization
DENTAL GROUP WEST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKEY L VAN SWEDEN (PRESIDENT)
(616) 785-3344
Entity
Organization
Contact information
Practice address
1063 4 MILE RD NW, GRAND RAPIDS, MI 49544-7398
(616) 785-3344
(616) 785-4013
Mailing address
1063 4 MILE RD NW, GRAND RAPIDS, MI 49544-7398
(616) 785-3344
(616) 785-4013
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901010289
MI
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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