| NPI | 1194855155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BAKOS Finance Supervisor 616-632-7244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| 261QD0000X Clinic/Center Dental (Licence: MI 2901020199) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2018-02-28 |