| NPI | 1174031264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LOUIS AURELIA Owner 248-651-6810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901018604) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 2901018604) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2021-08-23 |