| NPI | 1023775632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARON WHATELEY Orthodontist 517-278-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2021-11-18 |