| NPI | 1386196798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN GAUTHIER Business Manager 906-399-0342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 2901021816) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2023-09-06 |