| NPI | 1114563012 |
|---|---|
| Doing Business As | HARBORSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARK DAVID KRULL Partner 231-946-0207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2019-11-26 |