| NPI | 1861270746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE BURKS Manager, Insurance Operations 989-327-7095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |