| NPI | 1407036437 |
|---|---|
| Other Name | NA |
| Entity Type | Organization |
| Authorized Contact | JAMES LOUIS WIELAND Dentist 616-241-2659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901011153) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |