| NPI | 1003997958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN DENTAMARO Office Manager 586-977-8413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901013204) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |