NPI | 1891455267 |
---|---|
Doing Business As | HARBORSIDE DENTAL |
Entity Type | Organization |
Authorized Contact | MARK DAVID KRULL Owner 231-218-3944 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-12-27 |
Last Update Date | 2021-12-27 |