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General NPI Number Information
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NPI Number | 1114152006
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Entity Type | Organization
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Legal Business Name | GINGRICH DENTAL PC
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Dates
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Enumeration Date | 05/20/2009
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 106 CHESTNUT ST
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City | BIG RAPIDS
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State | MI
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Zip | 49307-2206
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Country | US
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Telephone | 231-796-8715
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Fax | 231-796-6300
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Provider Business Mailing Address
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Address Line | 106 CHESTNUT ST
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City | BIG RAPIDS
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State | MI
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Zip | 49307-2206
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Country | US
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Telephone | 231-796-8715
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Fax | 231-796-6300
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARTHUR V GINGRICH
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Credential | DENTIST
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Telephone | 231-796-8715
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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 | 112970
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License Number State | MI
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