| NPI | 1124554886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD I SHANNIR Owner 313-271-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901016116) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |