| NPI | 1295862340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL H VANDERVEEN Owner 616-940-0940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 11356) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 18692) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-05-01 |