Provider Demographics
NPI:1922735091
Name:PRINS FAMILY DENTISTRY
Entity Type:Organization
Organization Name:PRINS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PRINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-730-5240
Mailing Address - Street 1:855 N DARLING AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-9662
Mailing Address - Country:US
Mailing Address - Phone:231-924-4650
Mailing Address - Fax:
Practice Address - Street 1:855 N DARLING AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-9662
Practice Address - Country:US
Practice Address - Phone:231-924-4650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental