| NPI | 1053199141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELIA DANOWSKI Office Manager 248-547-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-19 |