| NPI | 1053748889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE LORAY MCCLENIC Owner Hygienist 313-407-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MI 2902010375) |
| Enumeration Date | 2013-10-12 |
| Last Update Date | 2013-10-12 |