Organization
TAG ORTHODONTICS PLLC
Active
Parent organization
TAG ORTHODONTICS PLLC
Other names
Paciorek Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAG ORTHODONTICS PLLC
Authorized official
STACY POPE (PROJECT MANAGER)
(616) 737-9401
Entity
Organization
Contact information
Practice address
4981 W GENESEE ST, CAMILLUS, NY 13031-2313
(315) 487-3335
Mailing address
5300 PATTERSON AVE SE STE 110, GRAND RAPIDS, MI 49512-9758
(616) 283-8867
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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