NPI | 1992863401 |
---|---|
Former Legal Business Name | JENSEN SHROYER ANDERSON PC |
Entity Type | Organization |
Authorized Contact | KEVIN TODD MATHEWSON Dentist Owner 231-796-3571 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901016945) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019404) |
1223G0001X Dentist, General Practice (Licence: MI 2901010102) | |
1223G0001X Dentist, General Practice (Licence: MI 2901019403) | |
Enumeration Date | 2006-12-05 |
Last Update Date | 2020-08-22 |