| NPI | 1336782135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW GRILLO Orthodontist 989-600-8037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |