| NPI | 1831570555 |
|---|---|
| Other Name | ADVANCE DENTAL |
| Entity Type | Organization |
| Authorized Contact | LISA KLEIN Office Manager 616-956-9183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901014274) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-10-06 |