Provider Demographics
NPI:1871599258
Name:PARTNERS IN DENTAL CARE PC
Entity type:Organization
Organization Name:PARTNERS IN DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:LOCKE
Authorized Official - Last Name:BEGEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:616-949-0230
Mailing Address - Street 1:2565 FOREST HILL AVE SE
Mailing Address - Street 2:STE 200
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7535
Mailing Address - Country:US
Mailing Address - Phone:616-949-0230
Mailing Address - Fax:616-949-1125
Practice Address - Street 1:2565 FOREST HILL AVE SE
Practice Address - Street 2:STE 200
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7535
Practice Address - Country:US
Practice Address - Phone:616-949-0230
Practice Address - Fax:616-949-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI088621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty