Individual
DR. CLARE ROYCE VAN WIEREN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
601 MICHIGAN AVE, SUITE 200, HOLLAND, MI 49423-4951
(616) 392-5573
(616) 392-9610
Mailing address
601 MICHIGAN AVE, SUITE 200, HOLLAND, MI 49423-4951
(616) 392-5573
(616) 392-9610
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901009802
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2980529
—
MI
05
—
4062988
—
MI
01
—
9757063760
BCBS MEDICAL NUMBER
MI
01
—
D098020
BCBS DENTAL NUMBER
MI
Enumeration date
12/02/2005
Last updated
07/09/2007
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