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General NPI Number Information
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NPI Number | 1700287448
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTH - MICHIGAN
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 781 36TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49548-2319
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Country | US
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Telephone | 616-685-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 781 36TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49548-2319
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS DIRECTOR
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Name | ROBERT KAMPHUIS
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Credential |
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Telephone | 616-685-3819
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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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