Organization
BRIAN CILLA DDS MS PC
Active
Other names
West Michigan Periodontics & Advanced Implant Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN LEE CILLA DDS MS (OWNER PRESIDENT)
(616) 531-1920
Entity
Organization
Contact information
Practice address
3145 PRAIRIE ST SW, SUITE 104, GRANDVILLE, MI 49418
(616) 531-1920
(616) 531-4275
Mailing address
3145 PRAIRIE ST SW, SUITE 104, GRANDVILLE, MI 49418
(616) 531-1920
(616) 531-4275
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
290104700
MI
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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