Individual
IGOR MAKOVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
4500 CASCADE RD SE STE 208, GRAND RAPIDS, MI 49546-3665
(616) 977-5000
(616) 977-0020
Mailing address
4500 CASCADE RD SE STE 208, GRAND RAPIDS, MI 49546-3665
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2901015669
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4301117131
MI
Other
Enumeration date
06/05/2012
Last updated
08/29/2022
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