| NPI | 1679062772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN M RIOPELLE CEO 616-268-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MI 16820) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-06-05 |