| NPI | 1205567849 |
|---|---|
| Doing Business As | ROSE STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DONALD WENTZLOFF Dentist 231-383-0382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-06-23 |