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General NPI Number Information
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NPI Number | 1497286876
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Entity Type | Organization
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Legal Business Name | CASCADE FAMILY DENTAL GROUP
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 6735 CASCADE RD SE SUITE 400
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6887
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Country | US
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Telephone | 616-975-9400
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Fax | 231-241-1114
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Provider Business Mailing Address
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Address Line | 6735 CASCADE RD SE SUITE 400
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6887
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Country | US
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Telephone | 616-975-9400
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Fax | 231-241-1114
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Authorized Official
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Title or Position | INSURANCE SPECIALIST
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Name | TERESA BEER
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Credential |
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Telephone | 231-246-2204
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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 | MI
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