Organization
JONATHAN D EAGLE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNATHAN D EAGLE DDS PC (PRESIDENT)
(616) 361-9330
Entity
Organization
Contact information
Practice address
1750 GRAND RIDGE COURT NE, SUITE 202, GRAND RAPIDS, MI 49525
(616) 361-9330
(616) 361-7095
Mailing address
1750 GRAND RIDGE COURT NE, SUITE 202, GRAND RAPIDS, MI 49525
(616) 361-9330
(616) 361-7095
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901015645
MI
Other
Enumeration date
02/07/2007
Last updated
11/22/2023
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