| NPI | 1144291832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA A DENIS Pres/Dds 734-856-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 29010014395) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901015738) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-08-22 |