| NPI | 1467240531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK JAMES RICE Owner 231-828-2594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |