| NPI | 1114941754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL HELLIE Member 734-665-0481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901010677) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |