| NPI | 1639232457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L VANDYKE Sole Proprietor 231-719-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901018623) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |