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General NPI Number Information
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NPI Number | 1306936141
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Entity Type | Individual
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Provider Name | PAUL F KORTE DDS
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3100 IVANREST AVE SW SUITE # 104
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City | GRANDVILLE
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State | MI
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Zip | 49418-2930
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Country | US
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Telephone | 616-531-0780
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Fax | 616-531-4677
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Provider Business Mailing Address
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Address Line | 1810 RIDGEMOOR DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-5145
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Country | US
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Telephone | 616-949-3516
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 10238
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License Number State | MI
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