Healthcare Provider Details

I. General information

NPI: 1952032385
Provider Name (Legal Business Name): JD ARBUTANTE DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 06/17/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17357 VAN WAGONER RD STE 1
SPRING LAKE MI
49456-8831
US

IV. Provider business mailing address

17357 VAN WAGONER RD STE 1
SPRING LAKE MI
49456-8831
US

V. Phone/Fax

Practice location:
  • Phone: 616-842-0090
  • Fax: 616-842-8970
Mailing address:
  • Phone: 616-842-0090
  • Fax: 616-842-8970

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. JOEY ARBUTANTE
Title or Position: PRESIDENT
Credential: DDS
Phone: 616-842-0090