| NPI | 1295986479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE A NESTER Owner 989-875-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 12204) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 14779) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2013-08-21 |