| NPI | 1639060452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY JAMES HAWKES Owner 517-376-0940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-17 |