| NPI | 1407213655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY STPHEN REVES General Dentistry/Owner 517-784-0897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 14737) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |