Organization
616 DENTAL STUDIO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCOS CID D.D.S. M.S. (DENTIST)
(616) 214-7865
Entity
Organization
Contact information
Practice address
171 MONROE AVE NW, GRAND RAPIDS, MI 49503-2634
(616) 214-7865
Mailing address
171 MONROE AVE NW, GRAND RAPIDS, MI 49503-2634
(616) 214-7865
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901020846
MI
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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