NPI | 1841315090 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN P MARCONNIT President 989-786-2104 |
Organization Subpart ? | No |
Primary Taxonomy | 292200000X Dental Laboratory (Licence: MI 13005) |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2007-03-20 |
Last Update Date | 2020-08-22 |