| NPI | 1629123229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD RUSSELL ROMESBURG Pres 616-353-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS-016814-L) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |