| NPI | 1376999433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLYSON BURGESS MULDER Dentist 616-453-5331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901020749) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-06-08 |