Individual
DR. EVAN DAVID OUDERKIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11970 SWEETWATER DR, GRAND LEDGE, MI 48837-8199
(517) 627-2470
Mailing address
1028 GRENOBLE CIR, LANSING, MI 48917-4811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600514APP20
MI
Other
Enumeration date
05/28/2020
Last updated
06/10/2020
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