| NPI | 1508313230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY GRAMBEAU Owner 231-347-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901011049) |
| Enumeration Date | 2016-09-11 |
| Last Update Date | 2016-09-11 |