Organization
MARK W. TOURNELL, D.D.S., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK TOURNELL D.D.S. (OWNER)
(616) 942-0840
Entity
Organization
Contact information
Practice address
5010 CASCADE RD SE, GRAND RAPIDS, MI 49546-3725
(616) 942-0840
Mailing address
5010 CASCADE RD SE, GRAND RAPIDS, MI 49546-3725
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
J11639
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275520199
NPI TYPE 1
MI
Enumeration date
09/17/2013
Last updated
04/13/2017
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