Organization
GRANDVILLE PEDIATRIC DENTRISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRIAN DEMETER DDS (PRESIDENT)
(616) 531-3430
Entity
Organization
Contact information
Practice address
3131 44TH ST SW, GRANDVILLE, MI 49418-2684
(616) 531-3430
Mailing address
3131 44TH ST SW, GRANDVILLE, MI 49418-2684
(616) 531-3430
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
17118
MI
Other
Enumeration date
07/26/2006
Last updated
08/22/2020
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