| NPI | 1023414695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ROBERT GASTON Owner 231-799-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 15602) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2014-11-10 |