| NPI | 1174925069 |
|---|---|
| Doing Business As | PINE RIVER DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | BRIAN J PUTMAN Member 989-875-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist (Licence: OH 30.023756) |
| 122300000X Dentist | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2023-02-17 |