| NPI | 1205928322 |
|---|---|
| Other Name | PROFESSIONAL CORPORATION |
| Entity Type | Organization |
| Authorized Contact | PATRICIA J HART General Manager 810-238-6260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |