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Organization

FERRIS STATE UNIVERSITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JAMIE FREITAG RDH (SEALANT COORDINATOR)
(231) 591-3130
Entity
Organization

Contact information

Practice address
200 FERRIS DR, BIG RAPIDS, MI 49307-2740
(231) 591-3130
Mailing address
200 FERRIS DR, BIG RAPIDS, MI 49307-2740
(231) 591-3130

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018836
MI
124Q00000X
Dental Hygienist
2902002544
MI
124Q00000X
Dental Hygienist
2902004089
MI
124Q00000X
Dental Hygienist
2902011248
MI

Other

Enumeration date
11/04/2014
Last updated
11/04/2014
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