| NPI | 1538724828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY WALDEMAR EASTON II Partner Dentist 810-357-5683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-02 |