| NPI | 1407671670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WRIGHT Management 616-826-8007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2024-12-02 |