| NPI | 1184283368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LLOYD MARTIN COCKING Operations Manager/In House Counsel 734-981-4909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |