| NPI | 1417671652 |
|---|---|
| Doing Business As | PROFILE ORTHODONTICS & FACIAL ORTHOPEDICS |
| Entity Type | Organization |
| Authorized Contact | GRANT ESSINK Owner 531-893-2928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2023-04-11 |