| NPI | 1104336049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN TIMOTHY SOLT Owner Dentist 810-338-0656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MI 2901021009) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-05 |