| NPI | 1053617639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENGTAO GUO Owner 734-425-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901020128) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2022-04-18 |