MEDICARE: HUDSONVILLE DENTISTRY PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1417824731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSONVILLE DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	2715 BERWYCK RD SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49506-4817
Country	:	US
Telephone Number	:	989-225-0753
Fax Number	:

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

Authorized Official
Title or Position	:	CEO
Name	:	DR. ADAM E PIOTROWSKI
Credential	:	DDS
Telephone Number	:	616-949-1570

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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