Organization
JERRY BURGESS MULDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY BURGESS MULDE4R DDS (DENTIST)
(616) 458-0631
Entity
Organization
Contact information
Practice address
426 MICHIGAN ST NE STE 207, GRAND RAPIDS, MI 49503-5608
(616) 458-0631
Mailing address
426 MICHIGAN ST NE STE 207, GRAND RAPIDS, MI 49503-5608
(616) 458-0631
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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