NPI | 1689254757 |
---|---|
Former Legal Business Name | SMILE SUITES DENTAL, PLLC |
Doing Business As | LAKETOWN FAMILY DENTAL |
Entity Type | Organization |
Authorized Contact | ERIC LENDBURGH HEISSER Member 231-670-2851 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2021-04-12 |
Last Update Date | 2022-03-04 |