| NPI | 1205217049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARZATTA MOORE President 586-558-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901014832) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |