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Contact Information

GRANDVILLE ENDODONTICS
3100 IVANREST AVE SW
SUITE 104
GRANDVILLE, MI49418-2930
 Phone: 616-531-0780
 Fax: 616-531-4677
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for GRANDVILLE ENDODONTICS

NPI Number 1508031808
LBN Legal business name GRANDVILLE ENDODONTICS
Authorized official BRIAN LICARI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/28/2008
Last updated 04/28/2008 - About 18 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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