| NPI | 1043936123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONI MALLIA Owner 734-426-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2023-05-30 |