| NPI | 1801319025 |
|---|---|
| Doing Business As | WHITE LAKE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | GRANT GILLISH Owner/Dentist 231-893-2915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901020310) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-07-21 |