Individual
TARA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 CHERRY ST SE, GRAND RAPIDS, MI 49503-4748
(616) 235-7289
Mailing address
550 CHERRY ST SE, GRAND RAPIDS, MI 49503-4748
(616) 235-7289
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902017296
MI
Other
Enumeration date
11/23/2015
Last updated
11/23/2015
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