Tough Teeth & Great Gums

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

2901010721 Issued in MI

Legal business name

TOUGH TEETH & GREAT GUMS

Practice address

1866 10 Mile Rd NE
Comstock Park, MI 49321-9669

Phone

(616) 460-6369

NPI assigned

Aug 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amy Elizabeth Broekstra, RDH

Title

Director

Phone

(616) 460-6369

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1104073410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 10 MILE RD NE",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493219669",
            "telephone_number": "616-460-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 10 MILE RD NE",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493219669",
            "telephone_number": "616-460-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOUGH TEETH & GREAT GUMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "BROEKSTRA",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "616-460-6369",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "MI",
            "license": "2901010721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Schneider
• Allan Smith, RN
• Bruce Alexander Stewart Jr., D.D.S.
• Stacie Stewart
• Jeffrey Michael Thompson, O.D.
• Gary L Vandyken, MD
• Stacey Lynn Visockis
• Janice K Wabeke, D.O.
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP

• Public Health Dentistry in Comstock Park, MI
• Providers in Comstock Park, MI by specialty
• Public Health Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.