NPI | 1114323664 |
---|---|
Doing Business As | CLARK AND VANOVERLOOP FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | AARON SAMUEL CLARK Dentist / Member 616-457-6800 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2014-11-11 |
Last Update Date | 2020-10-21 |