| NPI | 1588767123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES IAN MCLAREN President 989-754-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901018085) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901018086) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |