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Individual

PATRICK JAMES CONDIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2541 INDIAN TRL SE, GRAND RAPIDS, MI 49506-3116
(616) 560-7384
Mailing address
2541 INDIAN TRL SE, GRAND RAPIDS, MI 49506-3116

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019.028956
IL
122300000X
Dentist
Primary
2901021476
MI
122300000X
Dentist
30-02-3894
OH

Other

Enumeration date
06/17/2011
Last updated
07/09/2015
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