| NPI | 1942354725 |
|---|---|
| Doing Business As | JACKSON CENTER FOR COSMETIC AND RESTORATIVE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | DARYL WILLIAM FREDERICK Owner 517-787-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 10125) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |