| NPI | 1043609738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALISHA LEONE MORIN Partner 616-396-1058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 290101169) |
| Enumeration Date | 2015-01-18 |
| Last Update Date | 2015-01-18 |