Provider Demographics
NPI:1588326730
Name:THORNAPPLE DENTAL PLC
Entity type:Organization
Organization Name:THORNAPPLE DENTAL PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERHOOF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-309-0236
Mailing Address - Street 1:3195 NATURE VIEW DR SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-9348
Mailing Address - Country:US
Mailing Address - Phone:989-309-0236
Mailing Address - Fax:
Practice Address - Street 1:6886 CASCADE RD SE STE G
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6879
Practice Address - Country:US
Practice Address - Phone:616-940-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental