| NPI | 1497318992 |
|---|---|
| Doing Business As | BLUE WATER DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | DAVID M KELLY President/ Dds 734-777-0289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-04-19 |