Organization
MARY BERNONA STEVENS DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY BERNONA STEVENS DDS (OWNER)
(616) 560-5740
Entity
Organization
Contact information
Practice address
1172 NIXON AVE NW, GRAND RAPIDS, MI 49534-3638
(616) 453-0644
(616) 453-0646
Mailing address
1172 NIXON AVE NW, GRAND RAPIDS, MI 49534-3638
(616) 453-0644
(616) 453-0646
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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