| NPI | 1407020548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERE BOOTH MEADE Treasurer 616-895-7199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901013664) |
| Enumeration Date | 2008-04-19 |
| Last Update Date | 2008-04-19 |