| NPI | 1972804904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD EDWARD LEBLANC President/Owner 989-631-8913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901018503) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2010-11-08 |