Individual
ERIC J FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
630 36TH ST SW, GRAND RAPIDS, MI 49509-4005
(616) 538-4330
(616) 538-5353
Mailing address
630 36TH ST SW, GRAND RAPIDS, MI 49509-4005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018395
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4936691
—
MI
01
—
D18395
BLUE CROSS BLUE SHIELD
MI
Enumeration date
04/10/2007
Last updated
07/08/2007
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