MEDICARE: HARBOR HILLS, PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901020276	MI

General Provider Information

NPI Number	:	1184020331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOR HILLS, PLC

Provider Business Mailing Address
First Line	:	3185 CORPORATE GROVE DR
Second Line	:	STE A
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-8021
Country	:	US
Telephone Number	:	616-896-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3185 CORPORATE GROVE DR
Second Line	:	STE A
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-8021
Country	:	US
Telephone Number	:	616-896-7600
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. KRISTEN VELTEMA
Credential	:	D.M.D.
Telephone Number	:	616-896-7600

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	03/24/2016

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