| NPI | 1740548270 |
|---|---|
| Other Name | GREAT LAKES BAY HEALTH CENTERS MOBILE DENTAL 1 |
| Entity Type | Organization |
| Authorized Contact | LISA M 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 | 2012-05-03 |
| Last Update Date | 2021-12-02 |