Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Fresh Coast Pediatric Dentistry

Organization Dental Clinic/Center · NPI 1629982939

Fresh Coast Pediatric Dentistry provides Dental Clinic/Center services in Grand Rapids, Michigan. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

933 3 Mile Rd NW Ste 102
Grand Rapids, MI 49544-1673
Phone: (616) 606-3811
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1629982939
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Taryn Weil — Owner · (616) 606-3811
NPI enumeratedOctober 1, 2026
Last updated in NPPESOctober 1, 2026
Certification dateOctober 1, 2026
Mailing address820 Gladstone Dr Se, Grand Rapids, MI 49506-3334

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