Organization
JASON C. DOUBLESTEIN, D.D.S., P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON C DOUBLESTEIN D.D.S., P.L.L.C. (PRESIDENT)
(616) 530-2200
Entity
Organization
Contact information
Practice address
4320 44TH ST SW, SUITE 106, GRANDVILLE, MI 49418-2300
(616) 530-2200
(616) 530-8250
Mailing address
4320 44TH ST SW, SUITE 106, GRANDVILLE, MI 49418-2300
(616) 530-2200
(616) 530-8250
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901018806
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386760072
DENTIST
MI
01
—
1952426371
DENTIST
MI
Enumeration date
09/03/2009
Last updated
09/08/2009
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