| NPI | 1942378419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DANIEL BERARD Dentist/Owner 616-392-2853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901019128) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 02097814533) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-02-03 |