Healthcare Provider Details

I. General information

NPI: 1730155599
Provider Name (Legal Business Name): ERIC JOHN ENGLISH D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 JUPITER AVE NE
BELMONT MI
49306-8708
US

IV. Provider business mailing address

6220 JUPITER AVE NE
BELMONT MI
49306-8708
US

V. Phone/Fax

Practice location:
  • Phone: 616-361-9387
  • Fax: 616-361-9231
Mailing address:
  • Phone: 616-361-9387
  • Fax: 616-361-9231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16315
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: