Fuller Avenue Dental Associates
Fuller Avenue Dental Associates provides General Practice Dentistry in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2007.
- Licensed in
- MI
- In the registry since
- 2007
- Specialties on file
- 2
Practice location Address checks out
2755 Fuller Ave NEGrand Rapids, MI 49505-3780
Phone: (616) 363-1136
Fax: (616) 363-4345
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 16615 (MI) |
|---|---|
| General Practice Dentistry | Taxonomy 1223G0001X · Licence 10428 (MI) |
Record details
| NPI number | 1639397615 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Shannon Visscher-Worst — Office Manager · (616) 363-1136 |
| NPI enumerated | April 23, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 2755 Fuller Ave Ne, Grand Rapids, MI 49505-3780 |
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