| NPI | 1942327259 |
|---|---|
| Other Name | WEST MICHIGAN PEDATRIC DENTISTRY, LLC |
| Entity Type | Organization |
| Authorized Contact | KATHY WISSINK Office Manager 616-392-2381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901012323) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2021-09-24 |