| NPI | 1770729048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILIANA MIREYE FINGLETON Owner 616-532-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MI 2901019111) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2022-04-19 |