| NPI | 1891225603 |
|---|---|
| Doing Business As | CAPITOL FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TYLER J JACQUES Registered Agent 989-980-2807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN1001691) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-09-18 |