| NPI | 1174665665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE MARIE RUSHLOW Office Manager 810-750-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 013363) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2008-10-18 |