Organization
OCULOPLASTIC ASSOCIATES OF WEST MICHIGAN, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY L KENT MD, PHD (OWNER, PHYSICIAN)
(616) 888-2948
Entity
Organization
Contact information
Practice address
4070 LAKE DR SE, SUITE 205, GRAND RAPIDS, MI 49546-8294
(616) 888-2948
(616) 888-2949
Mailing address
4070 LAKE DR SE, SUITE 205, GRAND RAPIDS, MI 49546-8294
(616) 888-2948
(616) 888-2949
Taxonomy
Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
4301092933
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164686812
NPI
—
Enumeration date
06/28/2016
Last updated
10/05/2016
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