| NPI | 1093570236 |
|---|---|
| Other Name | WAKE CROSS FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SHILPA KONERU Employee 248-462-3196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-02-16 |