NPI | 1194407460 |
---|---|
Doing Business As | THE VILLAGE DENTIST |
Entity Type | Organization |
Authorized Contact | KYLE BURKS Insurance Operations, Manager 989-327-7095 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2023-08-04 |
Last Update Date | 2023-08-04 |