| NPI | 1114182862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN ELIZABETH JOHNSON Owner 734-665-0481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017534) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |