| NPI | 1497117923 |
|---|---|
| Doing Business As | OLD MISSION DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MELISSA AYLWORTH Owner 231-223-4232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901019846) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-28 |