| NPI | 1255581419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA JUNE TYLER President 906-226-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901018861) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |