| NPI | 1154430718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARENE NICOLE RUMOHR Billing And Marketing Manager 734-677-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 18447) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 12814) |
| 122300000X Dentist (Licence: MI 12824) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2022-08-01 |