| NPI | 1427698851 |
|---|---|
| Doing Business As | GREAT LAKES DENTAL EXCELLENCE |
| Entity Type | Organization |
| Authorized Contact | MARY BETH HEGEDUS Prac Admin 231-799-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |