Organization
ALPINE FAMILY DENTISTRY ACQUISITION PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE JACKSON II DDS (OWNER)
(616) 784-4777
Entity
Organization
Contact information
Practice address
4040 ALPINE AVE NW, COMSTOCK PARK, MI 49321-8909
(616) 784-4777
Mailing address
4040 ALPINE AVE NW, COMSTOCK PARK, MI 49321-8909
(616) 784-4777
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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