Organization
SPRING LAKE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED M VANITTERSUM DDS (OWNER/DENTIST)
(616) 846-5690
Entity
Organization
Contact information
Practice address
102 S BUCHANAN ST, STE A, SPRING LAKE, MI 49456-2090
(616) 846-5690
(616) 846-6160
Mailing address
102 S BUCHANAN ST, STE A, SPRING LAKE, MI 49456-2090
(616) 846-5690
(616) 846-6160
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
E1557U
MI
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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