Provider Demographics
NPI:1356339089
Name:STRIKWERDA, SUSAN BEVING (DDS)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:BEVING
Last Name:STRIKWERDA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7117
Mailing Address - Country:US
Mailing Address - Phone:616-392-8668
Mailing Address - Fax:616-392-1691
Practice Address - Street 1:181 W 35TH ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7117
Practice Address - Country:US
Practice Address - Phone:616-392-8668
Practice Address - Fax:616-392-1691
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI138321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice