Fuller Avenue Dental Associates

LBN: Fuller Avenue Dental Associates
Fuller Avenue Dental Associates is an health care organization with primary practice located at 2755 Fuller Ave Ne , Grand Rapids MI 49505-3780. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Fuller Avenue Dental Associates can be contacted via phone (616) 363-1136, or through Visscher-Worst, Shannon Marie via phone (616) 363-1136.

Contact Information

Primary practice address
2755 Fuller Ave Ne Grand Rapids MI 49505-3780
Phone: (616) 363-1136
Fax: (616) 363-4345
Website:
Map and Directions
Authorized official contact:
Name: Visscher-Worst, Shannon Marie
Phone: (616) 363-1136

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 16615 Michigan
Dental Providers / General Practice 1223G0001X 10428 Michigan

Profile Details

NPI number 1639397615
LBN Legal business name Fuller Avenue Dental Associates
DBA Doing business as
Authorized official Visscher-Worst, Shannon Marie
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2007
Last updated Aug 22nd, 2020 - about 6 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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