| NPI | 1679538342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY R BEAUCHAMP Owner 810-765-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2902025117) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2902025321) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901015324) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2020-08-22 |