| NPI | 1942366919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN F MCMAHON Member 616-457-2710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901013305) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |