Organization
MICHIGAN CENTER FOR TMJ SLEEP DISORDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY B MULDER JR. DDS (OWNER)
(616) 458-0631
Entity
Organization
Contact information
Practice address
515 MICHIGAN ST NE, STE 202, GRAND RAPIDS, MI 49503
(616) 458-0631
Mailing address
515 MICHIGAN ST NE STE 202, GRAND RAPIDS, MI 49503-5721
(616) 458-0631
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MI
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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