Individual
DR. ROBERT BRUCE VANDRAGT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
431 MUNSON AVE, SUITE F, TRAVERSE CITY, MI 49686-3060
(231) 946-2160
(231) 946-2161
Mailing address
431 MUNSON AVE, SUITE F, TRAVERSE CITY, MI 49686-3060
(231) 946-2160
(231) 946-2161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901011357
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4040757
—
MI
Enumeration date
02/05/2007
Last updated
07/09/2007
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