| NPI | 1154050300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE CHRISTINE MILLER Practice Owner, Dentist 734-255-5240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2022-06-05 |