Bander Dental Group

LBN: Mattson Dental, Pllc
Bander Dental Group is an health care organization with primary practice located at 1151 E Paris Ave Se Ste 100 , Grand Rapids MI 49546-8369. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Suppliers / Customized Equipment. Dental Providers / General Practice is the primary health care specialty. Mattson Dental, Pllc can be contacted via phone (616) 949-5980, or through Bollinger, Carmen via phone (616) 706-7637.

Contact Information

Primary practice address
1151 E Paris Ave Se Ste 100 Grand Rapids MI 49546-8369
Phone: (616) 949-5980
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bollinger, Carmen
Phone: (616) 706-7637

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X
Suppliers / Customized Equipment 332BC3200X

Profile Details

NPI number 1437740313
LBN Legal business name Mattson Dental, Pllc
DBA Doing business as Bander Dental Group
Authorized official Bollinger, Carmen
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2021
Last updated Jul 18th, 2024 - about 2 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 1437740313 NPPES
Michigan MEDICAID 1710240007

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