MEDICARE: ERIN NARTKER 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
1	1223G0001X	General Practice Dentistry	2901022584	MI
2	122300000X	Dentist	2901022584	MI

General Provider Information

NPI Number	:	1619469046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN NARTKER DDS

Provider Business Mailing Address
First Line	:	336 MANHATTAN RD SE
Second Line	:
City	:	E GRAND RAPID
State	:	MI
Zip	:	49506-2019
Country	:	US
Telephone Number	:	248-921-3436
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 LEONARD ST NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49504-3827
Country	:	US
Telephone Number	:	616-453-5331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2018
Last Update Date	:	03/22/2023

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