| NPI | 1295145092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPAN PRAVIN PATEL Dentist 616-443-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019028510) |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2014-05-01 |