| NPI | 1659013472 |
|---|---|
| Doing Business As | COPPER RIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | DEREK JAMES RICE Owner/Provider 231-946-2497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-07-20 |