| NPI | 1629088943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M. BAIR Secretary/Treasurer 517-646-8226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901014382) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901014378) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-08-20 |