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General NPI Number Information
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NPI Number | 1093668691
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Entity Type | Organization
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Legal Business Name | THORNAPPLE RIVER DENTISTRY PLLC
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 6715 OLD 28TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6923
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Country | US
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Telephone | 616-949-0730
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Fax |
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Provider Business Mailing Address
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Address Line | 6800 ADASIDE DR SE
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City | ADA
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State | MI
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Zip | 49301-9161
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Country | US
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Telephone | 616-914-8619
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDRA TRAPP
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Credential | DDS
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Telephone | 616-914-8619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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