| NPI | 1063588242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT WESLEY Owner 248-720-5358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901015295) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2019-08-20 |