Organization
REDISKE DENTAL PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL RYAN REDISKE DDS (PRESIDENT)
(616) 443-6546
Entity
Organization
Contact information
Practice address
6543 28TH AVE, HUDSONVILLE, MI 49426-8856
(616) 443-6546
Mailing address
6543 28TH AVE, HUDSONVILLE, MI 49426-8856
(616) 443-6546
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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