| NPI | 1104958420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JOHN THANOS President 906-863-9203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MI 10281) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |