| NPI | 1033659503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH MARYAM ABOONA Provider/Owner 586-752-6596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2020-04-23 |