| NPI | 1710769724 |
|---|---|
| Doing Business As | GREAT LAKES BAY HEALTH CENTERS MOBILE DENTAL 4 |
| Entity Type | Organization |
| Authorized Contact | LISA GALONSKA Vice President 989-759-6448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 347B00000X Bus |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2023-10-16 |