Healthcare Provider Details

I. General information

NPI: 1063648038
Provider Name (Legal Business Name): ERIC ENGLISH DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 06/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 JUPITER AVE NE SUITE A
BELMONT MI
49306-8708
US

IV. Provider business mailing address

6220 JUPITER AVE NE SUITE A
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 Code261QD0000X
TaxonomyDental Clinic/Center
License Number2901016315
License Number StateMI

VIII. Authorized Official

Name: DR. ERIC JOHN ENGLISH
Title or Position: OWNER
Credential: DDS
Phone: 616-361-9387