Provider Demographics
NPI:1124731831
Name:SCOTT VANSLAMBROUCK DENTISTRY, PC
Entity type:Organization
Organization Name:SCOTT VANSLAMBROUCK DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-394-4700
Mailing Address - Street 1:455 BUTTERNUT DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1503
Mailing Address - Country:US
Mailing Address - Phone:616-394-4700
Mailing Address - Fax:
Practice Address - Street 1:455 BUTTERNUT DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-1503
Practice Address - Country:US
Practice Address - Phone:616-394-4700
Practice Address - Fax:616-394-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental