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1740602846
PURA VIDA SMILES, PC
JACKSON, MI
NPI
1740602846
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Entity Type
Organization
Authorized Contact
JASON BERTOLLINI
Prm
866-273-8204
Organization Subpart ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MI 15663)
Enumeration Date
2014-01-09
Last Update Date
2014-01-09
Business Address
PURA VIDA SMILES, PC
1113 BOARDMAN RD
JACKSON, MI 49202-1901
Phone number: 517-768-8100
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Mailing Address
PURA VIDA SMILES, PC
PO BOX 3189
SYRACUSE, NY 13220-3189
Phone number: 866-273-8204
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