| NPI | 1457658163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALLEN BLAESING President 517-265-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 11270) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |