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NPI Code Detail

MEDICARE: DR. DAVID MICHAEL POSTHUMUS DDS

MEDICARE:  DR. DAVID MICHAEL POSTHUMUS  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2901021973MI

General Provider Information

NPI Number : 1467803080
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID MICHAEL POSTHUMUS DDS
Provider Business Mailing Address
First Line : 2300 3 MILE RD NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49505-3956
Country : US
Telephone Number : 616-363-3712
Fax Number :
Provider Business Practice Location Address
First Line : 2300 3 MILE RD NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49505-3956
Country : US
Telephone Number : 616-363-3712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2016
Last Update Date : 06/24/2016

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Directions to “ DR. DAVID MICHAEL POSTHUMUS DDS” Practice Location

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