Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jerry Burgess Mulder Jr., DDSPLC

Individual provider Dentist · NPI 1104943398

Dr. Jerry Burgess Mulder Jr., DDSPLC is a Dentist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007

Practice location Address checks out

515 Michigan St NE Ste 202
Grand Rapids, MI 49503-5721
Phone: (616) 458-0631
Fax: (616) 458-4065
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D126890 (MI)

Record details

NPI number1104943398
Entity typeIndividual (Type 1)
GenderMale
Credentials DDSPLC
Sole proprietorNo
NPI enumeratedMarch 23, 2007
Last updated in NPPESJuly 8, 2015

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