| NPI | 1134570997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE M SPINEK General Manager 586-727-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901020657) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MI 2901021820) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |