| NPI | 1578963237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB E MYERS Owner 517-337-0032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 20163) |
| Enumeration Date | 2014-09-01 |
| Last Update Date | 2014-09-01 |