| NPI | 1013074095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHARLES SACKETT Dentist 269-345-8893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 14741) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |