Individual
C PHILIP DOEZEMA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2003 BURTON SE, GRAND RAPIDS, MI 49506-4600
(616) 243-7836
(616) 243-7874
Mailing address
2003 BURTON SE, GRAND RAPIDS, MI 49506-4600
(616) 243-7836
(616) 243-7874
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29010112283
MI
Other
Enumeration date
01/30/2006
Last updated
07/08/2007
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