| NPI | 1205384963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA A MCCANN Financial Coordinator 989-631-1334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MI 2901016864) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |