| NPI | 1992311021 |
|---|---|
| Doing Business As | GREAT LAKES FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JULIE PERRY Business COO Rdinator 810-744-1324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2020-09-23 |