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NPI Code Detail

MEDICARE: DR. JOHN ALFRED OSTROWSKI D.D.S

MEDICARE: DR. JOHN ALFRED OSTROWSKI D.D.S
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 Dentistry015378MI

General Provider Information

NPI Number : 1881817070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ALFRED OSTROWSKI D.D.S
Provider Business Mailing Address
First Line : 2249 WEALTHY ST SE
Second Line : SUITE 100
City : GRAND RAPIDS
State : MI
Zip : 49506-3052
Country : US
Telephone Number : 616-454-8228
Fax Number : 616-454-8968
Provider Business Practice Location Address
First Line : 2249 WEALTHY ST SE
Second Line : SUITE 100
City : GRAND RAPIDS
State : MI
Zip : 49506-3052
Country : US
Telephone Number : 616-454-8228
Fax Number : 616-454-8968
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 04/21/2015

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