Healthcare Provider Details

I. General information

NPI: 1306585880
Provider Name (Legal Business Name): DENTURES-IN-A-DAY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/02/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6045 DIVISION AVE S
GRAND RAPIDS MI
49548-6728
US

IV. Provider business mailing address

6045 DIVISION AVE S
GRAND RAPIDS MI
49548-6728
US

V. Phone/Fax

Practice location:
  • Phone: 616-531-7701
  • Fax:
Mailing address:
  • Phone: 616-531-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN L THOMPSON
Title or Position: DENTIST
Credential:
Phone: 616-531-7701