| NPI | 1316110778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD STANCHINA President 906-228-7173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI j14145) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2016-11-01 |