NPI | 1891176210 |
---|---|
Doing Business As | GREAT LAKES BAY HEALTH CENTERS SHIAWASSEE DENTAL |
Entity Type | Organization |
Authorized Contact | LISA GALONSKA Vice President 989-729-4848 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2015-06-11 |
Last Update Date | 2016-09-26 |