| NPI | 1114367000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C. O'DONALD Owner 616-754-7414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901013186) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-06-25 |