Organization
DETTMANN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA K DETTMANN M.D. (OWNER)
(616) 350-3230
Entity
Organization
Contact information
Practice address
3501 LAKE EASTBROOK BLVD SE STE 100, GRAND RAPIDS, MI 49546-5939
(616) 350-3230
Mailing address
3501 LAKE EASTBROOK BLVD SE STE 100, GRAND RAPIDS, MI 49546-5939
(616) 350-3230
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
4301051003
—
Other
Enumeration date
10/09/2014
Last updated
09/27/2016
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