| NPI | 1871599258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANIE LOCKE BEGEMAN Practice Administrator 616-949-0230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 08862) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2011-07-27 |