NPI | 1396276333 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREW JAMES BALAZE Dentist/Owner 517-787-5055 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: MI 2901020967) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2017-03-22 |
Last Update Date | 2019-08-07 |