| NPI | 1194817734 |
|---|---|
| Former Legal Business Name | MARY ANN BUKOWSKI DDS |
| Entity Type | Organization |
| Authorized Contact | MARY ANN BUKOWSKI Owner Dentist 269-381-0564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901011980) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |