Healthcare Provider Details

I. General information

NPI: 1659251585
Provider Name (Legal Business Name): YMC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 LAKE EASTBROOK BLVD SE STE 212
GRAND RAPIDS MI
49546-5989
US

IV. Provider business mailing address

3737 LAKE EASTBROOK BLVD SE STE 212
GRAND RAPIDS MI
49546-5989
US

V. Phone/Fax

Practice location:
  • Phone: 616-258-1473
  • Fax:
Mailing address:
  • Phone: 616-258-1473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDON CHURCHMAN
Title or Position: DENTIST/OWNER
Credential: DDS,PA-C
Phone: 616-258-1473