Organization
MICHAEL H. VANDERVEEN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL H VANDERVEEN D.D.S. (OWNER)
(616) 940-0940
Entity
Organization
Contact information
Practice address
2865 CLYDE PARK AVE SW, WYOMING, MI 49509-2911
(616) 940-0940
Mailing address
2865 CLYDE PARK AVE SW, WYOMING, MI 49509-2911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11356
MI
1223G0001X
General Practice Dentistry
18692
MI
Other
Enumeration date
02/27/2007
Last updated
05/01/2012
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