| NPI | 1053530352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN K. GIAMMALVA Owner 810-227-4224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901017224) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |