NPI | 1376787762 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK F. MCGOVERN Partner 906-228-9594 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI mm015901) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI ms19101) |
1223G0001X Dentist, General Practice (Licence: MI rp010017) | |
Enumeration Date | 2009-04-29 |
Last Update Date | 2009-04-29 |