| NPI | 1285462168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA DORLAND President 810-964-3521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-08-19 |