| Edward D Young Dds Pc | |
|
4310 Leonard Nw Grand Rapids MI 49534 | |
| (616) 791-0230 | |
| Not Available |
| Full Name | Edward D Young Dds Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4310 Leonard Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Edward D Young (PRESIDENT) |
| Authorized Official Contact | 6167910230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward D Young Dds Pc 4310 Leonard Nw Grand Rapids MI 49534 Ph: (616) 791-0230 | Edward D Young Dds Pc 4310 Leonard Nw Grand Rapids MI 49534 Ph: (616) 791-0230 |
| NPI Number | 1154414886 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154414886 | NPI | - | NPPES |
| 4563730 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 2901013995 (Michigan) | Primary |
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