Provider Demographics
NPI:1700410354
Name:LANGHORST FAMILY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:LANGHORST FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MEMBER, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGHORST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-948-1214
Mailing Address - Street 1:3235 N WELLNESS DR STE A-240
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-7264
Mailing Address - Country:US
Mailing Address - Phone:616-377-7708
Mailing Address - Fax:
Practice Address - Street 1:3235 N WELLNESS DR STE A-240
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-7264
Practice Address - Country:US
Practice Address - Phone:616-377-7708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-22
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental