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General NPI Number Information
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NPI Number | 1588290951
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Entity Type | Organization
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Legal Business Name | DANIEL W GRODE PLLC
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 1726 LEONARD ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-5636
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Country | US
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Telephone | 616-459-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 1726 LEONARD ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-5636
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Country | US
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Telephone | 616-459-0478
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DANIEL W GRODE
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Credential | DDS
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Telephone | 734-560-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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