Organization
DE YOUNG DENTAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL SCOTT DE YOUNG DDS (CEO)
(616) 821-3851
Entity
Organization
Contact information
Practice address
1869 PORTER ST SW, WYOMING, MI 49519-1709
(616) 532-7601
Mailing address
1869 PORTER ST SW, WYOMING, MI 49519-1709
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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