| NPI | 1366896490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHN MCDONALD Owner 989-773-2133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 14262) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2021-12-14 |