| NPI | 1386415651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT KINGMA Member 616-942-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |