| NPI | 1962286674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LEWIS SINCLAIR Ownder 269-344-2652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-08-23 |