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General NPI Number Information
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NPI Number | 1770846834
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Entity Type | Individual
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Provider Name | GEORGE KIRBY M.D, D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 601 MICHIGAN AVE STE 200
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City | HOLLAND
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State | MI
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Zip | 49423
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Country | US
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Telephone | 616-392-2329
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Fax | 616-392-9610
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Provider Business Mailing Address
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Address Line | 6440 OAKRIDGE DR
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City | HOLLAND
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State | MI
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Zip | 49423-8999
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Country | US
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Telephone | 989-621-4044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2901020465
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License Number State | MI
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