Individual
DR. JACOB COLBERT LUEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
706 W RANDALL ST, COOPERSVILLE, MI 49404-1308
(616) 837-7604
(616) 837-6549
Mailing address
600 MONROE AVE NW, LOFT 205, GRAND RAPIDS, MI 49503-1473
(616) 717-0218
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901018860
MI
Other
Enumeration date
07/25/2007
Last updated
01/08/2009
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