| NPI | 1144589003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J STEVENSON Owner Dentist 734-994-0909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901018803) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MI 2902014363) |
| 124Q00000X Dental Hygienist (Licence: MI 2902009162) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |