| NPI | 1063420578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KOZICKI President 248-689-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 015334) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-12-17 |