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Organization

44 WEST DENTAL PROFESSIONALS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON C DOUBLESTEIN DDS (CO-OWNER)
(616) 530-2200
Entity
Organization

Contact information

Practice address
4330 44TH ST SW STE 105, GRANDVILLE, MI 49418-2349
(616) 530-2200
(616) 530-8250
Mailing address
4330 44TH ST SW STE 105, GRANDVILLE, MI 49418-2349
(616) 530-2200
(616) 530-8250

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018806
MI
122300000X
Dentist
2901020644
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386760072
DENTIST
MI
01
1578823993
DENTIST
MI
01
1760829444
DENTIST
MI
Enumeration date
06/11/2015
Last updated
10/09/2019
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