Provider Demographics
NPI:1407115587
Name:DENTAL MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:DENTAL MEDICAL SERVICES INC.
Other - Org Name:DIVERSIFIED MEDICAL STAFFING, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:CORNELIUS
Authorized Official - Last Name:FERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-942-2222
Mailing Address - Street 1:2025 E BELTLINE AVE SE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7630
Mailing Address - Country:US
Mailing Address - Phone:616-942-2222
Mailing Address - Fax:616-942-2228
Practice Address - Street 1:2025 E BELTLINE AVE SE
Practice Address - Street 2:SUITE 310
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7630
Practice Address - Country:US
Practice Address - Phone:616-942-2222
Practice Address - Fax:616-942-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care