| NPI | 1407390107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI L JENNINGS Practice Manager 517-789-8622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 21829) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 19622) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |