| NPI | 1902551351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIKA SCHOTT Financial Coordinator 616-583-7307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-02-15 |