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Organization

VAN DE VYVER DENTAL, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN VAN DE VYVER (DENTIST)
(734) 320-8939
Entity
Organization

Contact information

Practice address
25810 KELLY RD STE 2, ROSEVILLE, MI 48066-4467
(734) 320-8939
Mailing address
73501 WINDMILL DR, BRUCE TWP, MI 48065-3159
(586) 372-7045

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
02/19/2020
Last updated
02/19/2020
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