| NPI | 1073744173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER NICOLE OSBORNE Office Manager 517-482-0885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901018410) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 901013605) |
| 122300000X Dentist (Licence: MI 012271) | |
| 122300000X Dentist (Licence: MI 2901019279) | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |