| NPI | 1215481155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN FRANCINE NICKODEMUS Dentist 734-769-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017670) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |