| NPI | 1518311786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ROGERS Director Of Finance 616-669-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901011799) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2021-01-15 |