| NPI | 1235519356 |
|---|---|
| Doing Business As | GRAND TRAVERSE DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | CARMEN WOODS Credentialing Coordinator 217-540-5141 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-07-06 |