| NPI | 1073655593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY HERBERT WEISS Treasurer 313-563-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 2901011363) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |