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General NPI Number Information
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NPI Number | 1649229493
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Entity Type | Organization
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Legal Business Name | WESTSHORE ENDODONTICS, P.C.
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 904 S WASHINGTON AVE SUITE 110
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City | HOLLAND
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State | MI
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Zip | 49423-7724
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Country | US
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Telephone | 616-392-6385
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Fax | 616-392-9779
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Provider Business Mailing Address
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Address Line | 904 S WASHINGTON AVE SUITE 110
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City | HOLLAND
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State | MI
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Zip | 49423-7724
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Country | US
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Telephone | 616-392-6385
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Fax | 616-392-9779
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Authorized Official
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Title or Position | ENDODONTIST
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Name | DR. JAMES RAY HOWARD
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Credential | D.D.S., M.S.
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Telephone | 616-392-6385
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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 | 2901010230
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License Number State | MI
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