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General NPI Number Information
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NPI Number | 1609134022
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Entity Type | Organization
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Legal Business Name | COMFORT FAMILY DENTISTRY OF ZEELAND
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 156 E CHERRY AVE
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City | ZEELAND
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State | MI
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Zip | 49464-1724
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Country | US
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Telephone | 616-772-9898
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Fax | 616-772-9915
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Provider Business Mailing Address
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Address Line | 156 E CHERRY AVE
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City | ZEELAND
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State | MI
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Zip | 49464-1724
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Country | US
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Telephone | 616-772-9898
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Fax | 616-772-9915
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN K TOTH
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Credential | DMD
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Telephone | 616-772-9898
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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 | 2901019487
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License Number State | MI
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