| NPI | 1932839982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL ANDERSON Owner 989-835-5261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2024-02-29 |