Provider Demographics
NPI:1396967287
Name:WINN, DENNIS EDWARD II (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:EDWARD
Last Name:WINN
Suffix:II
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:60 MONROE CENTER ST NW APT 10C
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2919
Mailing Address - Country:US
Mailing Address - Phone:616-299-6146
Mailing Address - Fax:
Practice Address - Street 1:1179 E PARIS AVE SE STE 220
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3682
Practice Address - Country:US
Practice Address - Phone:616-957-3977
Practice Address - Fax:616-575-9296
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010135361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics