NPI | 1194962753 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY MISCH Manager 734-975-1743 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 2901019093) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MI 2901018946) |
Enumeration Date | 2009-01-19 |
Last Update Date | 2009-01-19 |