| NPI | 1174374664 |
|---|---|
| Doing Business As | MODERN DENTISTRY OF CLARKSTON |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOHN OBRADOVICH Dentist 248-625-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |