| NPI | 1801060702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL WAYNE CHAMBERS President 616-949-4650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 17046) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |