| NPI | 1174695522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC W BRUST Owner 313-299-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 15547) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2014-10-22 |