Provider Demographics
NPI:1427527779
Name:H2G DENTAL PLLC
Entity type:Organization
Organization Name:H2G DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GROENEVELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-225-4392
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-0460
Mailing Address - Country:US
Mailing Address - Phone:586-727-0990
Mailing Address - Fax:
Practice Address - Street 1:540 S PARKER ST
Practice Address - Street 2:
Practice Address - City:MARINE CITY
Practice Address - State:MI
Practice Address - Zip Code:48039-3593
Practice Address - Country:US
Practice Address - Phone:810-765-1440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOTOR CITY DENTAL PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-15
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty