Organization
CEDARROCK DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD L JERUZAL DDS (PRESIDENT)
(616) 866-4461
Entity
Organization
Contact information
Practice address
4655 14 MILE RD NE, ROCKFORD, MI 49341
(616) 866-4461
(616) 696-3420
Mailing address
4655 14 MILE RD NE, ROCKFORD, MI 49341
(616) 866-4461
(616) 696-3420
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10232
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4051090
—
MI
Enumeration date
03/10/2006
Last updated
08/22/2020
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