| NPI | 1043480254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J. NIVISON President 810-742-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 14588) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-04 |