| NPI | 1275766461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON C DOUBLESTEIN President 616-530-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901018806) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2009-09-08 |