Organization
CONTEMPORARY FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY A DYKSTRA DDS (OWNER)
(616) 669-6600
Entity
Organization
Contact information
Practice address
2005 BRETON RD SE, GRAND RAPIDS, MI 49546
(616) 926-1271
(616) 726-1273
Mailing address
2005 BRETON RD SE, GRAND RAPIDS, MI 49546
(616) 726-1271
(616) 726-1273
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11799
MI
122300000X
Dentist
12554
MI
122300000X
Dentist
18713
MI
122300000X
Dentist
19719
MI
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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