| NPI | 1235453804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT EDWARD VAN TIMMEREN Dentist/President 616-538-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901019579) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2016-05-25 |