| NPI | 1083011233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL PELTON President 586-731-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 14192) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 13626) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |