Organization
DWIGHT J MONSMA DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EWA BARBARA OSTROWSKI (BUSINESS ADMINISTRATOR)
(616) 942-9891
Entity
Organization
Contact information
Practice address
3521 LAKE EASTBROOK BLVD SE, GRAND RAPIDS, MI 49546
(616) 942-9891
(616) 942-9891
Mailing address
3521 LAKE EASTBROOK BLVD SE, GRAND RAPIDS, MI 49546
(616) 942-9891
(616) 942-9894
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901008106
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4063994
—
MI
Enumeration date
11/27/2006
Last updated
08/22/2020
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