| NPI | 1023774460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN FRAWLEY Office Manager 517-439-9394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2021-11-10 |