| NPI | 1144622655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA MARY GUDMUNDSEN President 517-321-2358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 15606) |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2014-09-16 |