| NPI | 1659251585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON CHURCHMAN Dentist/Owner 616-258-1473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |