| NPI | 1053374215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD MARTELLA Dentist 248-545-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 12200) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2020-08-22 |