| Gaines Pediatric Dentistry Pllc | |
|
1559 68th St Se Grand Rapids MI 49508-7015 | |
| (616) 258-2005 | |
| Not Available |
| Full Name | Gaines Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1559 68th St Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Daniel Ocallaghan (MEMBER) |
| Authorized Official Contact | 6163757467 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaines Pediatric Dentistry Pllc 1100 Giddings Ave Se Grand Rapids MI 49506-3255 Ph: () - | Gaines Pediatric Dentistry Pllc 1559 68th St Se Grand Rapids MI 49508-7015 Ph: (616) 258-2005 |
| NPI Number | 1306213814 |
|---|---|
| Provider Enumeration Date | 09/01/2015 |
| Last Update Date | 09/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306213814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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