Organization
FIRST FRUITS DENTAL, PC
Active
Other names
Bowtie Dental
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL BRUEN (HR)
(616) 532-9003
Entity
Organization
Contact information
Practice address
1621 44TH ST SW STE 200, WYOMING, MI 49509-4387
(616) 532-9003
Mailing address
1621 44TH ST SW STE 200, WYOMING, MI 49509-4387
(616) 532-9003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/26/2017
Last updated
07/21/2022
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