| NPI | 1972750826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCINDA K MICHELIN Practice Administration 231-933-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901013774) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2008-08-22 |