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General NPI Number Information
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NPI Number | 1104942697
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Entity Type | Individual
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Provider Name | MICHAEL SCOTT PALASZEK DDS
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2150 LAKE MICHIGAN DR NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504
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Country | US
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Telephone | 616-453-8211
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Fax | 616-453-3277
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Provider Business Mailing Address
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Address Line | 4554 LOGGERS RUN NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525
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Country | US
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Telephone | 616-364-5114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 013189
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License Number State | MI
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