| NPI | 1689645053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL E. LUEDER Owner 231-775-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 11088) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MI 11025) |
| 1223G0001X Dentist General Practice (Licence: MI 11842) | |
| 1223G0001X Dentist General Practice (Licence: MI 15351) | |
| 1223G0001X Dentist General Practice (Licence: MI 19225) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2012-01-27 |