| NPI | 1083739262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHA J. D'SILVA Laboratory Director 734-764-1543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2014-02-04 |