| NPI | 1659980308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER NASON Office Manager 616-895-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |