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General NPI Number Information
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NPI Number | 1316467954
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Entity Type | Individual
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Provider Name | HENDRIK VANHOLSBEECK DDS
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Gender | Male
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Dates
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Enumeration Date | 06/25/2017
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Last Update Date | 06/25/2017
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Provider Practice Location Address
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Address Line | 2515 ALPINE AVE NW # A
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City | GRAND RAPIDS
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State | MI
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Zip | 49544
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Country | US
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Telephone | 616-364-9348
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Fax |
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Provider Business Mailing Address
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Address Line | 626 GLADSTONE DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-2819
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Country | US
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Telephone | 248-921-3062
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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 | 2901022220
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License Number State | MI
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