| NPI | 1194204636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RENZEMA Dentist 616-396-8320 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901008507) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-12-12 |