Healthcare Provider Details

I. General information

NPI: 1285546408
Provider Name (Legal Business Name): GRUTTER DENTAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6785 MYERS LAKE AVE NE STE A
ROCKFORD MI
49341-7415
US

IV. Provider business mailing address

6785 MYERS LAKE AVE NE STE A
ROCKFORD MI
49341-7415
US

V. Phone/Fax

Practice location:
  • Phone: 616-874-6040
  • Fax:
Mailing address:
  • Phone: 616-874-6040
  • 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: DR. BARON GRUTTER
Title or Position: OWNER
Credential: DDS
Phone: 816-866-0064