| NPI | 1144494733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA REED Office Manager 248-540-0120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI PA10994) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2015-05-21 |