Individual
DR. PAUL JAY HUIZINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MD
Contact information
Practice address
4330 44TH ST SW, SUITE 106, GRANDVILLE, MI 49418-2349
(616) 530-4710
(616) 530-0480
Mailing address
3919 PIUTE DR SW, GRANDVILLE, MI 49418-2474
(616) 534-4477
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2901018332
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4453238
—
MI
Enumeration date
08/24/2005
Last updated
08/24/2010
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