| NPI | 1114101318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON C SHUNK General Partner 906-635-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901014320) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901010627) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2007-12-24 |