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General NPI Number Information
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NPI Number | 1871599258
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Entity Type | Organization
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Legal Business Name | PARTNERS IN DENTAL CARE PC
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 2565 FOREST HILL AVE SE STE 200
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7535
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Country | US
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Telephone | 616-949-0230
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Fax | 616-949-1125
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Provider Business Mailing Address
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Address Line | 2565 FOREST HILL AVE SE STE 200
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7535
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Country | US
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Telephone | 616-949-0230
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Fax | 616-949-1125
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DR. JANIE LOCKE BEGEMAN
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Credential | DDS
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Telephone | 616-949-0230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 08862
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License Number State | MI
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