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General NPI Number Information
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NPI Number | 1578952032
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Entity Type | Organization
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Legal Business Name | A A DOERING ENDODONTICS PLLC
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 2450 44TH ST SE 201
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City | GRAND RAPIDS
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State | MI
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Zip | 49512-9081
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Country | US
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Telephone | 616-224-3636
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Fax | 616-224-3644
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Provider Business Mailing Address
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Address Line | 2450 44TH ST SE 201
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City | GRAND RAPIDS
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State | MI
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Zip | 49512-9081
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Country | US
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Telephone | 616-224-3636
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Fax | 616-224-3644
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARTHUR LOUIS DOERING
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Credential | DDS MS
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Telephone | 616-224-3636
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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 | 1376609222
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 1760779177
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License Number State | MI
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