| NPI | 1225135429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY WILLIAM JOHNSON Dentist 517-374-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MI 9995) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |