Organization
ORAL & MAXILLOFACIAL SURGERY OF GREATER GRAND RAPIDS LLC
Active
Other names
Bradley G. VanHoose
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY G VANHOOSE GARRETT VANHOOSE DDS MS (ORAL SURGEON)
(616) 891-1700
Entity
Organization
Contact information
Practice address
9021 N RODGERS CT SE STE A, CALEDONIA, MI 49316-7650
(616) 891-1700
(616) 891-9306
Mailing address
9021 N RODGERS CT SE STE A, CALEDONIA, MI 49316-7650
(616) 891-1700
(616) 891-9306
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134177942
NPI
MI
Enumeration date
01/08/2020
Last updated
01/08/2020
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