Organization
MI SMILES DENTAL CASCADE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILIANA HUMPHREY (ADMINISTRATIVE ASSISTANT)
(616) 379-4011
Entity
Organization
Contact information
Practice address
4990 CASCADE RD SE, GRAND RAPIDS, MI 49546-8416
(616) 777-5199
Mailing address
3250 CENTRAL BLVD, HUDSONVILLE, MI 49426-1439
(616) 669-6600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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