| Kingma Pediatric Dentistry Pllc | |
|
1179 E Paris Ave Se Ste 130 Grand Rapids MI 49546-3682 | |
| (616) 942-9840 | |
| (616) 942-0170 |
| Full Name | Kingma Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1179 E Paris Ave Se Ste 130, Grand Rapids, Michigan |
| Authorized Official Name and Position | Amanda Merren (OFFICE MANAGER) |
| Authorized Official Contact | 6165519701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingma Pediatric Dentistry Pllc 1179 E Paris Ave Se Ste 130 Grand Rapids MI 49546-3682 Ph: (616) 942-9840 | Kingma Pediatric Dentistry Pllc 1179 E Paris Ave Se Ste 130 Grand Rapids MI 49546-3682 Ph: (616) 942-9840 |
| NPI Number | 1811465990 |
|---|---|
| Provider Enumeration Date | 11/07/2018 |
| Last Update Date | 11/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811465990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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