| NPI | 1073992483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN EDWARD GORK President 248-353-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 12696) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |