Organization
GRAND RIVER PEDIATRIC DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGHAN DUBOIS CONDIT DDS (MEMBER)
(734) 250-4494
Entity
Organization
Contact information
Practice address
7758 20TH AVE, JENISON, MI 49428
(734) 250-4494
Mailing address
7758 20TH AVE, JENISON, MI 49428-8524
(616) 777-3300
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
12/18/2019
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