| NPI | 1417066077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN GILBERT PARAMO Owner Dentist 231-547-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901015752) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |