| NPI | 1275721532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN CLAIR HYLAND Owner 269-382-0482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901017013) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-11-05 |