Organization
HEINZ ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY VANGEMERT (ADMINISTRATION)
(616) 656-4155
Entity
Organization
Contact information
Practice address
158 MARCELL DR NE STE A, ROCKFORD, MI 49341-1393
(616) 951-3006
Mailing address
6208 KALAMAZOO AVE SE STE 3, GRAND RAPIDS, MI 49508-7893
(616) 656-4155
(616) 656-4156
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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