Individual
MR. EZEQUIEL RIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
669 STOCKING AVE NW, GRAND RAPIDS, MI 49504-5176
(616) 235-7507
Mailing address
669 STOCKING AVE NW, GRAND RAPIDS, MI 49504-5176
(616) 235-7507
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902016085
MI
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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