| NPI | 1689752537 |
|---|---|
| Doing Business As | 36TH STREET DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | ERIC JOHN FOSTER Dentist 616-538-4330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901018395) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |