Great Lakes Jaw Surgery, Pc

LBN: Great Lakes Jaw Surgery, Pc
Great Lakes Jaw Surgery, Pc is an health care organization with primary practice located at 2017 Eastcastle Dr Se Suite C, Grand Rapids MI 49508-8872. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Great Lakes Jaw Surgery, Pc can be contacted via phone (616) 281-2370, or through Rosema, Robert John via phone (616) 281-2370.

Contact Information

Primary practice address
2017 Eastcastle Dr Se Suite C Grand Rapids MI 49508-8872
Phone: (616) 281-2370
Fax: (616) 281-2801
Website:
Map and Directions
Authorized official contact:
Name: Rosema, Robert John Doctor of Dental Surgery (DDS)
Phone: (616) 281-2370

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 2901011345 Michigan

Profile Details

NPI number 1326291816
LBN Legal business name Great Lakes Jaw Surgery, Pc
DBA Doing business as
Authorized official Rosema, Robert John Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 28th, 2008
Last updated Jul 28th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326291816 NPPES
Michigan MEDICAID 10-2978271

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