| NPI | 1346508124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY W MANCEWICZ Owner/Dentist 616-455-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901011327) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2012-04-30 |