| NPI | 1619549540 |
|---|---|
| Doing Business As | ORCHARD GROVE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | KATIE LAUREN MACKEN Dentist/Owner 980-999-0435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2021-07-12 |