| NPI | 1124153762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA TUMPKINMCQUEEN Owner 248-559-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 2901015114) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |