| NPI | 1881290526 |
|---|---|
| Doing Business As | WELLSPRING DENTAL |
| Entity Type | Organization |
| Authorized Contact | RANDALL SHAW Owner 248-931-1151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2020-12-08 |