| NPI | 1114524881 |
|---|---|
| Doing Business As | GRAND RAPIDS FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | KATELYN PALMATEER Member 810-650-3511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |