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Individual

DR. JONATHAN EAGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1750 GRAND RIDGE COURT NE, SUITE 202, GRAND RAPIDS, MI 49525
(616) 361-9330
(616) 361-7095
Mailing address
1750 GRAND RIDGE COURT NE, SUITE 202, GRAND RAPIDS, MI 49525
(616) 361-9330
(616) 361-7095

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D156450
MI

Other

Enumeration date
12/10/2007
Last updated
11/22/2023
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