| NPI | 1972679504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EWA BARBARA OSTROWSKI Business Administrator 616-942-9891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901008106) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-08-22 |