Individual
BRIDGET NUCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 S BEECHTREE ST, GRAND HAVEN, MI 49417-2839
(616) 850-3970
Mailing address
16128 GARY, GRAND HAVEN, MI 49417-9414
(732) 832-5331
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601263
MI
122300000X
Dentist
2951000852
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
02/21/2021
Last updated
06/29/2022
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